Provider Demographics
NPI:1336127760
Name:CARESOUTH HHA HOLDINGS OF GREENSBORO, LLC
Entity Type:Organization
Organization Name:CARESOUTH HHA HOLDINGS OF GREENSBORO, LLC
Other - Org Name:ENHABIT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRISSY
Authorized Official - Middle Name:BUCHANAN
Authorized Official - Last Name:CARLISLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-239-6500
Mailing Address - Street 1:6688 N CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3950
Mailing Address - Country:US
Mailing Address - Phone:214-239-6500
Mailing Address - Fax:214-239-6581
Practice Address - Street 1:5 OAK BRANCH DR STE 5E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2169
Practice Address - Country:US
Practice Address - Phone:336-274-6937
Practice Address - Fax:336-274-7448
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENHABIT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-05
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0303251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC34D1022619OtherCLIA
NC3427173Medicaid
NC3427173Medicaid
34-7173Medicare ID - Type Unspecified
NC347173Medicare Oscar/Certification