PIEDMONT VILLAGE AT STATESVILLE, INC.
Assisted Living Facility
Statesville, North Carolina
Provider NPI: 1578583381
Organization Information:Organization Name: PIEDMONT VILLAGE AT STATESVILLE, INC.
Practice Location:
1902 ORA DR STATESVILLE, NC 28625 US
Tel: 704-878-6376 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:
1902 ORA DR STATESVILLE, NC 28625 US
Tel: 704-878-6376 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | NC | HAL-049-014 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
7803560 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin