Healthcare Provider Details

I. General information

NPI: 1144317033
Provider Name (Legal Business Name): MCDOWELL HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 DAIRY DR
NEBO NC
28761-6810
US

IV. Provider business mailing address

PO BOX 706
GLEN ALPINE NC
28628-0706
US

V. Phone/Fax

Practice location:
  • Phone: 828-584-6811
  • Fax: 828-584-6811
Mailing address:
  • Phone: 828-584-6811
  • Fax: 828-584-6811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL-059-018
License Number StateNC

VIII. Authorized Official

Name: MR. PATRICK BARLOW
Title or Position: ADMINISTRATOR
Credential:
Phone: 828-584-6811