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General NPI Number Information
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NPI Number | 1225157365
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Entity Type | Organization
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Legal Business Name | CHESTNUT PARK REST HOME #1
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 64 CHESTNUT PARK DR
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City | WAYNESVILLE
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State | NC
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Zip | 28786-4180
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Country | US
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Telephone | 828-452-1102
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Fax | 828-456-9857
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Provider Business Mailing Address
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Address Line | 64 CHESTNUT PARK DR
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City | WAYNESVILLE
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State | NC
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Zip | 28786-4180
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Country | US
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Telephone | 828-452-1102
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Fax | 828-456-9857
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. FRANCES SMITH
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Credential |
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Telephone | 828-452-1002
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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 | HAL044002
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License Number State | NC
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