# LUTHERAN HOME-HICKORY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215110499
- **Authorized official:** MRS. AMBER MCINTOSH (ADMINISTRATOR)
- **Authorized official phone:** (828) 328-2006

## Contact information

- **Practice address:** 1265 21ST ST NE, HICKORY, NC 28601-2911
- **Practice address phone:** (828) 328-2006
- **Practice address fax:** (828) 327-0512
- **Mailing address:** 1265 21ST ST NE, HICKORY, NC 28601-2911
- **Mailing address phone:** (828) 328-2006
- **Mailing address fax:** (828) 327-0512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0068 | NC | Yes |

## Other

- **Enumeration date:** 12/11/2007
- **Last updated:** 01/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5298520001 | DURABLE MEDICAL EQUIPMENT | NC |
| 01 | — | 5325960001 | DURABLE MEDICAL EQUIPMENT | NC |