1306096904 NPI number — HIGHER EXPECTATIONS, LLC

Table of content: (NPI 1306096904)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306096904 NPI number — HIGHER EXPECTATIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHER EXPECTATIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BRIGHTSTAR HEALTHCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306096904
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6701 ABERDEEN AVE
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79424-1519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-745-9996
Provider Business Mailing Address Fax Number:
806-745-9998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 ABERDEEN AVE
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-745-9996
Provider Business Practice Location Address Fax Number:
806-745-9998
Provider Enumeration Date:
09/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KANE
Authorized Official First Name:
LONNY
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-745-9996

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 013786 . This is a "TX DEPT. OF AGING AND DISABILITY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 261QP2000X . This is a "HOME INFUSSION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 506344 . This is a "THE JOINT COMMISSION ACREDIDATION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2083X0100X . This is a "OCUPATIONAL THERAPY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001019584 . This is a "MDCP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 235Z00000X . This is a "SPEECH THERAPY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 280295101 . This is a "TPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 45D2004174 . This is a "CLIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 251E00000X HOME HEAL . This is a "TAXONIMY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 261-QP2000X . This is a "PHYSICAL THERAPY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 280295101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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