Healthcare Provider Details

I. General information

NPI: 1609994821
Provider Name (Legal Business Name): BMMGH-OPGH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 DREXEL RD
MORGANTON NC
28655-8322
US

IV. Provider business mailing address

6883 BURKEMONT RD
MORGANTON NC
28655-7673
US

V. Phone/Fax

Practice location:
  • Phone: 828-439-8041
  • Fax: 828-439-8041
Mailing address:
  • Phone: 828-439-8041
  • Fax: 828-439-8041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberMHL 012-091
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberMHL012118
License Number StateNC

VIII. Authorized Official

Name: TONIA CARPENTER DONNELL
Title or Position: PRESIDENT
Credential:
Phone: 828-439-8041