Provider Demographics
NPI:1770559932
Name:HOME HEALTH PROFESSIONALS OF GUILFORD, INC.
Entity type:Organization
Organization Name:HOME HEALTH PROFESSIONALS OF GUILFORD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-679-8852
Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7253
Mailing Address - Country:US
Mailing Address - Phone:336-884-8869
Mailing Address - Fax:336-884-8098
Practice Address - Street 1:1701 WESTCHESTER DR
Practice Address - Street 2:SUITE 275
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7253
Practice Address - Country:US
Practice Address - Phone:336-884-8869
Practice Address - Fax:336-884-8098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1286251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3407211Medicaid
NC3407211Medicaid