Provider Demographics
NPI:1518003854
Name:HIGH COUNTRY HOME CARE, INC.
Entity Type:Organization
Organization Name:HIGH COUNTRY HOME CARE, INC.
Other - Org Name:HIGH COUNTRY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-733-1248
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-0658
Mailing Address - Country:US
Mailing Address - Phone:828-733-1248
Mailing Address - Fax:828-733-9064
Practice Address - Street 1:430 PINEOLA ST
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-8865
Practice Address - Country:US
Practice Address - Phone:828-733-1248
Practice Address - Fax:828-733-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
NCHC11353747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408620Medicaid