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General NPI Number Information
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NPI Number | 1275726317
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Entity Type | Organization
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Legal Business Name | LEAN'S FAMILY CARE HOME
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 1020 E STAGECOACH TRL
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City | LAWNDALE
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State | NC
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Zip | 28090-9553
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Country | US
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Telephone | 704-538-9053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2177
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City | SHELBY
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State | NC
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Zip | 28151-2177
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | ANDRE MCCLUNEY
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Credential |
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Telephone | 704-477-0382
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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-023-036
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License Number State | NC
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