Healthcare Provider Details

I. General information

NPI: 1982944328
Provider Name (Legal Business Name): EARL ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 LOVING WAY
CLYDE NC
28721-9471
US

IV. Provider business mailing address

251 SHELTON ST
WAYNESVILLE NC
28786-3362
US

V. Phone/Fax

Practice location:
  • Phone: 828-828-4520
  • Fax:
Mailing address:
  • Phone: 828-456-8365
  • Fax: 828-456-6792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL-044-039
License Number StateNC

VIII. Authorized Official

Name: MR. AARON D CRAWFORD
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 828-456-8365