Provider Demographics
NPI:1588992549
Name:HIGHLAND HEALTHCARE, LLC
Entity type:Organization
Organization Name:HIGHLAND HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BRANCH MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENITA
Authorized Official - Middle Name:BERNELL
Authorized Official - Last Name:TRUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-409-6762
Mailing Address - Street 1:4264 N FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5001
Mailing Address - Country:US
Mailing Address - Phone:479-443-0600
Mailing Address - Fax:479-443-0601
Practice Address - Street 1:4264 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5001
Practice Address - Country:US
Practice Address - Phone:479-443-0600
Practice Address - Fax:479-443-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care