Healthcare Provider Details

I. General information

NPI: 1235284555
Provider Name (Legal Business Name): LIFEFORCE HOME HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 11/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 YADKINVILLE RD FORSYTH CENTRE
PFAFFTOWN NC
27040-9252
US

IV. Provider business mailing address

7270 REYNOLDA RD ONE REYNOLDA CENTRE
PFAFFTOWN NC
27040-9759
US

V. Phone/Fax

Practice location:
  • Phone: 336-924-0451
  • Fax: 336-924-0452
Mailing address:
  • Phone: 336-922-2219
  • Fax: 336-923-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberHC3680
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC3680
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberHC3680
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberHC3680
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License NumberHC3680
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License NumberHC3680
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHC3680
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberHC3680
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHC3680
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHC3680
License Number StateNC

VIII. Authorized Official

Name: SHELIA SCALES-SMITH
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 336-922-2219