Provider Demographics
NPI:1891275798
Name:HOME CARE SPECIALIST IN THE MOUNTAINS, INC
Entity Type:Organization
Organization Name:HOME CARE SPECIALIST IN THE MOUNTAINS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-349-9500
Mailing Address - Street 1:PO BOX 2234
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-2234
Mailing Address - Country:US
Mailing Address - Phone:828-349-9500
Mailing Address - Fax:828-349-9501
Practice Address - Street 1:232 CUNNINGHAM RD STE 2
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-9524
Practice Address - Country:US
Practice Address - Phone:828-349-9500
Practice Address - Fax:828-349-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4347374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC146788767Medicaid