CAMELOT MANOR INC
Alzheimer Center
Granite Falls, North Carolina
Provider NPI: 1720188915
Organization Information:Organization Name: CAMELOT MANOR INC
Practice Location:
56 N HIGHLAND AVE DBA BROCKFORD INN INC GRANITE FALLS, NC 28630 US
Tel: 828-396-3111 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:
56 N HIGHLAND AVE DBA BROCKFORD INN INC GRANITE FALLS, NC 28630 US
Tel: 828-396-3111 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | NC | HAL-014-014 |
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | NC | HAL-014-014 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
STATE NUMBER | 600480534 | NC | 01 |
7805030 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin