Healthcare Provider Details

I. General information

NPI: 1730371303
Provider Name (Legal Business Name): CAROLINA CARE HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 PISGAH RD
ANDREWS NC
28901
US

IV. Provider business mailing address

PO BOX 34
CHEHALIS WA
98532
US

V. Phone/Fax

Practice location:
  • Phone: 828-361-0843
  • Fax: 828-837-0843
Mailing address:
  • Phone: 360-269-3283
  • Fax: 360-864-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. NANCY L ANDERSON
Title or Position: PRESIDENT
Credential: RN CRNA
Phone: 360-269-3283