Healthcare Provider Details

I. General information

NPI: 1023879632
Provider Name (Legal Business Name): DOC HILLS FAMILY CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 SPRING ST
HAMLET NC
28345-2657
US

IV. Provider business mailing address

PO BOX 1123
HAMLET NC
28345-1123
US

V. Phone/Fax

Practice location:
  • Phone: 910-894-2504
  • Fax: 910-516-1714
Mailing address:
  • Phone: 910-894-2504
  • Fax: 910-516-1714

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
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: LUARLEEN HILL
Title or Position: OWNER
Credential:
Phone: 910-894-2504