Provider Demographics
NPI:1982948550
Name:GIVENS HIGHLAND FARMS, LLC
Entity type:Organization
Organization Name:GIVENS HIGHLAND FARMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:FARKAS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:828-357-2003
Mailing Address - Street 1:200 TABERNACLE ROAD
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711
Mailing Address - Country:US
Mailing Address - Phone:828-669-6473
Mailing Address - Fax:828-669-2817
Practice Address - Street 1:200 TABERNACLE ROAD
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711
Practice Address - Country:US
Practice Address - Phone:828-669-6473
Practice Address - Fax:828-669-2817
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIVENS ESTATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-20
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
NCNH0147314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3415078Medicaid
345078Medicare PIN