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General NPI Number Information
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NPI Number | 1164873790
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Entity Type | Organization
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Legal Business Name | ANNS FAMILY CARE #6
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 3120 TUCKLAND DR
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City | RALEIGH
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State | NC
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Zip | 27610-5257
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Country | US
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Telephone | 919-713-0930
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Fax | 919-790-6990
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Provider Business Mailing Address
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Address Line | 5312 SIX FORKS RD STE 301
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City | RALEIGH
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State | NC
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Zip | 27609-4458
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Country | US
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Telephone | 919-713-0930
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Fax | 919-790-6990
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Authorized Official
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Title or Position | CFO/DIRECTOR OF OPERATIONS
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Name | MS. SANDRA MAYO
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Credential |
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Telephone | 919-713-0930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-092-225
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License Number State | NC
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