Healthcare Provider Details

I. General information

NPI: 1861256695
Provider Name (Legal Business Name): GUIDED LIVING SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2004 HUNTERWOODS DR
HIGH POINT NC
27265-9573
US

IV. Provider business mailing address

2004 HUNTERWOODS DR
HIGH POINT NC
27265-9573
US

V. Phone/Fax

Practice location:
  • Phone: 336-303-0292
  • Fax:
Mailing address:
  • Phone: 336-303-0292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. VIVIAN DIANE PPRINCE
Title or Position: OWNER
Credential:
Phone: 336-303-0292