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ENTERPRISE HEALTHCARE OF STATESVILLE

Adult Care Home

Statesville, North Carolina

Provider NPI: 1417071457

Organization Information:
Organization Name:  ENTERPRISE HEALTHCARE OF STATESVILLE


Practice Location:
1942 VAN HAVEN DR  STATESVILLE, NC 28625 US
Tel: 704-878-0046  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
NCHAL-049-015

Other Provider Identifiers:

IssuerNumberStateType
7803811NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS NC - Page 1



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