Provider Demographics
NPI:1891330130
Name:GOODWORKS HEALTH MANAGEMENT, LLC
Entity Type:Organization
Organization Name:GOODWORKS HEALTH MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-409-4172
Mailing Address - Street 1:3425 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-5127
Mailing Address - Country:US
Mailing Address - Phone:336-409-4172
Mailing Address - Fax:
Practice Address - Street 1:3425 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-5127
Practice Address - Country:US
Practice Address - Phone:336-409-4172
Practice Address - Fax:336-217-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health