Healthcare Provider Details

I. General information

NPI: 1376674606
Provider Name (Legal Business Name): YANCEY INVESTMENT COMPANY DBA OAKHURST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 DEXTER AVE
GREENSBORO NC
27407-3616
US

IV. Provider business mailing address

3004 DEXTER AVE
GREENSBORO NC
27407-3616
US

V. Phone/Fax

Practice location:
  • Phone: 336-292-1349
  • Fax: 336-292-1306
Mailing address:
  • Phone: 336-292-1349
  • Fax: 336-292-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL-041-008
License Number StateNC

VIII. Authorized Official

Name: MR. PHILLIP MICHAEL STRADER
Title or Position: ADMINISTRATOR
Credential:
Phone: 336-292-1349