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General NPI Number Information
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NPI Number | 1114020286
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Entity Type | Organization
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Legal Business Name | HIGHLANDS HOME CARE, INC.
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 121 OAK RIDGE CT
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City | PRESTONSBURG
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State | KY
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Zip | 41653-8607
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Country | US
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Telephone | 606-889-9967
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Fax | 606-886-7633
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Provider Business Mailing Address
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Address Line | 121 OAK RIDGE CT P O BOX 757
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City | PRESTONSBURG
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State | KY
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Zip | 41653-8607
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Country | US
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Telephone | 606-889-9967
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Fax | 606-886-7633
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Authorized Official
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Title or Position | OPERATIONS ADMINISTRATOR
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Name | MR. CHARLES SHAG BRANHAM
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Credential |
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Telephone | 606-889-9967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 42050369
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 150178
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License Number State | KY
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