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General NPI Number Information
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NPI Number | 1275760548
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Entity Type | Organization
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Legal Business Name | PERSONAL TOUCH FAMILY CARE HOME #2
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 2610 HWY 130 WEST
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City | ROWLAND
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State | NC
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Zip | 28383-0002
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Country | US
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Telephone | 910-422-0121
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Fax | 910-422-3610
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Provider Business Mailing Address
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Address Line | 2610 HWY 130 WEST
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City | ROWLAND
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State | NC
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Zip | 28383-6902
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Country | US
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Telephone | 910-422-0121
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Fax | 910-422-3610
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EDNA L CHAVIS
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Credential |
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Telephone | 910-422-9998
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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 | FCL078019
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License Number State | NC
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