Healthcare Provider Details

I. General information

NPI: 1194590745
Provider Name (Legal Business Name): HHC INTEGRATED CLIENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 BERNARD STREET
GREENSBORO NC
27405-3724
US

IV. Provider business mailing address

3206 BERNARD STREET
GREENSBORO NC
27405-3724
US

V. Phone/Fax

Practice location:
  • Phone: 336-254-5118
  • Fax: 336-763-3653
Mailing address:
  • Phone: 336-254-5118
  • Fax: 336-763-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. DOREEN VIVIAN SMITH
Title or Position: CNA-R, CMA
Credential: CNA-R, CMA
Phone: 336-254-5118