Healthcare Provider Details

I. General information

NPI: 1982948550
Provider Name (Legal Business Name): GIVENS HIGHLAND FARMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TABERNACLE ROAD
BLACK MOUNTAIN NC
28711
US

IV. Provider business mailing address

200 TABERNACLE ROAD
BLACK MOUNTAIN NC
28711
US

V. Phone/Fax

Practice location:
  • Phone: 828-669-6473
  • Fax: 828-669-2817
Mailing address:
  • Phone: 828-669-6473
  • Fax: 828-669-2817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0147
License Number StateNC

VIII. Authorized Official

Name: SCOTT FARKAS
Title or Position: CONTROLLER
Credential: CPA
Phone: 828-357-2003