Healthcare Provider Details

I. General information

NPI: 1356514970
Provider Name (Legal Business Name): GARDEN TERRACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 SMITH GRAVEYARD RD
ASHEVILLE NC
28806-9005
US

IV. Provider business mailing address

154 SMITH GRAVEYARD RD
ASHEVILLE NC
28806-9005
US

V. Phone/Fax

Practice location:
  • Phone: 828-225-2746
  • Fax: 828-253-2618
Mailing address:
  • Phone: 828-225-2746
  • Fax: 828-253-2618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberFCL011274
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberFCL011270
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberFCL011274
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberFCL011270
License Number StateNC

VIII. Authorized Official

Name: MRS. LINDA MICHELLE HAMMOND
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 828-253-2618