WILKESBORO LIVIG CENTER LLC
Adult Care Home
Wilkesboro, North Carolina
Provider NPI: 1992942973
Organization Information:Organization Name: WILKESBORO LIVIG CENTER LLC
Practice Location:
176 RESTHOME RD WILKESBORO, NC 28697 US
Tel: 336-973-3890 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:
176 RESTHOME RD WILKESBORO, NC 28697 US
Tel: 336-973-3890 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 | HAL097012 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
LICENSE | HAL097012 | NC | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin