Hearthside Home Care Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HEARTHSIDE HOME CARE INC

Practice address

308 Pomona Dr Ste JKL
Greensboro, NC 27407-1665

Phone

(336) 808-1351

NPI assigned

Sep 26, 2006

Organization subpart

Yes

Parent organization

HEARTHSIDE HOME CARE INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tina Glenn

Title

President

Phone

(336) 455-3176

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• First Light Home Care of Jacksonville Doing business as
• FirstLight Home Care of Guilford Doing business as

Part of

Hearthside Home Care Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1205937851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 POMONA DR STE JKL",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071665",
            "telephone_number": "336-808-1351",
            "fax_number": "336-808-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 POMONA DR STE JKL",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071665",
            "telephone_number": "336-808-1351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Village Dr Ste 13",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285467071",
            "country_code": "US",
            "telephone_number": "910-939-0695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTHSIDE HOME CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTHSIDE HOME CARE INC.",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-455-3176"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1843",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409219",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Light Home Care of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "First Light Home Care of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FirstLight Home Care of Guilford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Greensboro, NC
• Providers in Greensboro, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.