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General NPI Number Information
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NPI Number | 1235460585
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Entity Type | Organization
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Legal Business Name | NICKANE PROP. LLC
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 75 KUYKENDALL BRANCH RD
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City | ASHEVILLE
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State | NC
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Zip | 28804-9612
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Country | US
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Telephone | 828-484-9813
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1810
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City | CANDLER
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State | NC
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Zip | 28715-1810
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Country | US
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Telephone | 828-216-8376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMMY TATE
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Credential |
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Telephone | 828-216-8376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | FCL-011-293
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License Number State | NC
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