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General NPI Number Information
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NPI Number | 1790495893
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Entity Type | Organization
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Legal Business Name | GOOD TIMES HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 2200 E MARKET ST STE B
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City | GREENSBORO
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State | NC
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Zip | 27401-6444
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Country | US
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Telephone | 336-291-8401
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 E MARKET ST STE B
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City | GREENSBORO
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State | NC
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Zip | 27401-6444
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Country | US
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Telephone | 336-300-1333
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. PORTIA LAJOY SHIPMAN
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Credential |
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Telephone | 336-300-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 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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