Provider Demographics
NPI:1861256695
Name:GUIDED LIVING SENIOR CARE LLC
Entity type:Organization
Organization Name:GUIDED LIVING SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:PPRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-303-0292
Mailing Address - Street 1:2004 HUNTERWOODS DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9573
Mailing Address - Country:US
Mailing Address - Phone:336-303-0292
Mailing Address - Fax:
Practice Address - Street 1:2004 HUNTERWOODS DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9573
Practice Address - Country:US
Practice Address - Phone:336-303-0292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care