Healthcare Provider Details

I. General information

NPI: 1568468577
Provider Name (Legal Business Name): HIGHLAND FARMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TABERNACLE RD
BLACK MOUNTAIN NC
28711-2592
US

IV. Provider business mailing address

200 TABERNACLE RD
BLACK MOUNTAIN NC
28711-2592
US

V. Phone/Fax

Practice location:
  • Phone: 828-669-6473
  • Fax: 828-669-6493
Mailing address:
  • Phone: 828-669-6473
  • Fax: 828-669-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0147
License Number StateNC

VIII. Authorized Official

Name: MRS. NANCY BALL
Title or Position: PATIENT ACCOUNTS COORDINATOR
Credential:
Phone: 828-669-6473