Provider Demographics
NPI:1922287770
Name:SMITHFIELD HOLDINGS, LLC
Entity Type:Organization
Organization Name:SMITHFIELD HOLDINGS, LLC
Other - Org Name:SMITHFIELD HOUSE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:828-738-3046
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-0269
Mailing Address - Country:US
Mailing Address - Phone:919-934-7708
Mailing Address - Fax:919-989-6695
Practice Address - Street 1:303 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4101
Practice Address - Country:US
Practice Address - Phone:828-738-3046
Practice Address - Fax:828-738-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL 051-027311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHAL051-027OtherLICENSE