Provider Demographics
NPI:1659538049
Name:PIEDMONT CHRISTIAN HOME INC
Entity Type:Organization
Organization Name:PIEDMONT CHRISTIAN HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-883-6023
Mailing Address - Street 1:1510 DEEP RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3448
Mailing Address - Country:US
Mailing Address - Phone:336-883-6023
Mailing Address - Fax:336-883-9977
Practice Address - Street 1:1510 DEEP RIVER RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3448
Practice Address - Country:US
Practice Address - Phone:336-883-6023
Practice Address - Fax:336-883-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801896Medicaid