Provider Demographics
NPI:1689002412
Name:HIGHSMITH FAMILY CARE HOME LLC
Entity Type:Organization
Organization Name:HIGHSMITH FAMILY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-483-5448
Mailing Address - Street 1:1446 SAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9566
Mailing Address - Country:US
Mailing Address - Phone:910-483-5448
Mailing Address - Fax:910-483-7975
Practice Address - Street 1:1446 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9566
Practice Address - Country:US
Practice Address - Phone:910-483-5448
Practice Address - Fax:910-483-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home