Healthcare Provider Details

I. General information

NPI: 1497979025
Provider Name (Legal Business Name): FIVE STAR INVESTMENTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 S NC 41 HWY
WALLACE NC
28466-7318
US

IV. Provider business mailing address

4002 S NC 41 HWY
WALLACE NC
28466-7318
US

V. Phone/Fax

Practice location:
  • Phone: 910-285-5352
  • Fax:
Mailing address:
  • Phone: 910-285-5352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberHAL031003
License Number StateNC

VIII. Authorized Official

Name: NINA C WILLIAMS
Title or Position: CO-OWNER
Credential:
Phone: 910-285-5352