Healthcare Provider Details

I. General information

NPI: 1619025467
Provider Name (Legal Business Name): PAKO INVESTMENTS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANSON HIGH SCHOOL RD
WADESBORO NC
28170
US

IV. Provider business mailing address

1105 BROOKSTOWN AVE
WINSTON SALEM NC
27101-2524
US

V. Phone/Fax

Practice location:
  • Phone: 704-994-9050
  • Fax: 704-695-1044
Mailing address:
  • Phone: 336-724-1000
  • Fax: 336-724-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberHAL-004-002
License Number StateNC

VIII. Authorized Official

Name: HARVEY LEAVITT
Title or Position: CEO
Credential:
Phone: 336-724-1000