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General NPI Number Information
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NPI Number | 1164585311
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Entity Type | Organization
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Legal Business Name | HIGH COUNTRY HOME CARE, INC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 496 BALSAM AVE
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City | SPRUCE PINE
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State | NC
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Zip | 28777-2606
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Country | US
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Telephone | 828-766-9977
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Fax | 828-766-7454
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | NEWLAND
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State | NC
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Zip | 28657-0658
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Country | US
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Telephone | 828-733-1248
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Fax | 828-733-9064
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE W WARE
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Credential |
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Telephone | 828-733-1248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HC1891
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License Number State | NC
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