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General NPI Number Information
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NPI Number | 1174855977
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Entity Type | Organization
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Legal Business Name | HEARTWINGS HIGHTS
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 3200 NORTHLINE AVE SUITE 115
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City | GREENSBORO
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State | NC
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Zip | 27408-7616
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Country | US
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Telephone | 336-455-9967
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Fax | 336-455-9888
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Provider Business Mailing Address
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Address Line | 3200 NORTHLINE AVE SUITE 115
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City | GREENSBORO
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State | NC
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Zip | 27408-7616
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Country | US
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Telephone | 336-455-9967
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Fax | 336-455-9888
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Authorized Official
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Title or Position | OWNER
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Name | MARTHE DIZON
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Credential |
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Telephone | 336-455-9967
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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 | HC3988
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License Number State | NC
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