Healthcare Provider Details

I. General information

NPI: 1356193890
Provider Name (Legal Business Name): HIGHER HEIGHTS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 COTTON CIR SE
WILSON NC
27893-6560
US

IV. Provider business mailing address

1815 FOREST HILLS RD W
WILSON NC
27893-3412
US

V. Phone/Fax

Practice location:
  • Phone: 252-243-0100
  • Fax:
Mailing address:
  • Phone: 919-943-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ETANYA LUCAS
Title or Position: CEO
Credential:
Phone: 919-438-4844