Provider Demographics
NPI:1558607689
Name:ALLEGHANY HIGHLANDS HOME CARE LLC
Entity Type:Organization
Organization Name:ALLEGHANY HIGHLANDS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:STONE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:540-965-1374
Mailing Address - Street 1:412 S LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-1908
Mailing Address - Country:US
Mailing Address - Phone:540-965-1374
Mailing Address - Fax:540-965-1384
Practice Address - Street 1:412 S LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-1908
Practice Address - Country:US
Practice Address - Phone:540-965-1374
Practice Address - Fax:540-965-1384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13897253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0168706924Medicaid
VA0168706411Medicaid
VA0168708466Medicaid