Healthcare Provider Details

I. General information

NPI: 1245701150
Provider Name (Legal Business Name): GOOD SHEPHERD ACQUISITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 09/06/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 NC HIGHWAY 69, STE. 11-A
HAYESVILLE NC
28904-6953
US

IV. Provider business mailing address

1101 KERMIT DR STE 204
NASHVILLE TN
37217-5102
US

V. Phone/Fax

Practice location:
  • Phone: 828-389-8106
  • Fax: 828-389-8484
Mailing address:
  • Phone: 615-365-4424
  • Fax: 615-365-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MCFADDIN-MILLS
Title or Position: SENIOR VP OF COMPLIANCE
Credential:
Phone: 615-365-4424