Provider Demographics
NPI:1679248389
Name:SIMMONS HOME CARE LLC
Entity Type:Organization
Organization Name:SIMMONS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:336-473-9274
Mailing Address - Street 1:1600 S ANDY GRIFFITH PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-2549
Mailing Address - Country:US
Mailing Address - Phone:336-429-2471
Mailing Address - Fax:
Practice Address - Street 1:1600 S ANDY GRIFFITH PKWY STE 1
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-2549
Practice Address - Country:US
Practice Address - Phone:336-429-2471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care