Provider Demographics
NPI:1952189821
Name:HIGHLY FAVORED FAMILY LLC
Entity Type:Organization
Organization Name:HIGHLY FAVORED FAMILY LLC
Other - Org Name:HIGHLY FAVORED FAMILY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JHOVANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ST LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-356-5647
Mailing Address - Street 1:750 KERR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3956
Mailing Address - Country:US
Mailing Address - Phone:845-248-4039
Mailing Address - Fax:
Practice Address - Street 1:750 KERR LAKE DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-3956
Practice Address - Country:US
Practice Address - Phone:845-248-4039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health