Provider Demographics
NPI:1326271479
Name:HIGHSMITH HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:HIGHSMITH HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-977-3206
Mailing Address - Street 1:144 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-3300
Mailing Address - Country:US
Mailing Address - Phone:910-321-1025
Mailing Address - Fax:910-321-1026
Practice Address - Street 1:144 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-3300
Practice Address - Country:US
Practice Address - Phone:910-321-1025
Practice Address - Fax:910-321-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3869251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health