CAROL LEE FAMILY CARE HOME
Adult Care Home
Liberty, North Carolina
Provider NPI: 1952423394
Organization Information:Organization Name: CAROL LEE FAMILY CARE HOME
Practice Location:
319 E RALEIGH AVE LIBERTY, NC 27298 US
Tel: 336-622-3002 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
319 E RALEIGH AVE LIBERTY, NC 27298 US
Tel: 336-622-3002 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | NC | FCL-076-021 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
7803999 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin