Provider Demographics
NPI:1790495893
Name:GOOD TIMES HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:GOOD TIMES HOME HEALTH CARE INC.
Other - Org Name:GOOD TIMES HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:LAJOY
Authorized Official - Last Name:SHIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-300-1333
Mailing Address - Street 1:2200 E MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6444
Mailing Address - Country:US
Mailing Address - Phone:336-300-1333
Mailing Address - Fax:
Practice Address - Street 1:2200 E MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6444
Practice Address - Country:US
Practice Address - Phone:336-291-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2520985OtherNORTH CAROLINA SECRETARY OF STATE