Healthcare Provider Details

I. General information

NPI: 1548452055
Provider Name (Legal Business Name): NEAL AND JOYCE PARSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 AILEEN AVE
BISCOE NC
27209
US

IV. Provider business mailing address

PO BOX 543
CANDOR NC
27229-0543
US

V. Phone/Fax

Practice location:
  • Phone: 910-428-9234
  • Fax: 910-974-4508
Mailing address:
  • Phone: 910-974-4373
  • Fax: 910-974-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberFCL062003
License Number StateNC

VIII. Authorized Official

Name: MRS. JOYCE L PARSONS
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 910-974-4373