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General NPI Number Information
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NPI Number | 1326278425
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Entity Type | Organization
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Legal Business Name | GIVE CHRIST ADULT CARE HOME
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 108 EASTWAY LN
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City | GRAHAM
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State | NC
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Zip | 27253-3704
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Country | US
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Telephone | 336-436-0219
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Fax | 336-270-3925
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Provider Business Mailing Address
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Address Line | 108 EASTWAY LN
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City | GRAHAM
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State | NC
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Zip | 27253-3704
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Country | US
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Telephone | 336-436-0219
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Fax | 336-270-3925
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANNIE CLAVON GILCHRIST
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Credential |
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Telephone | 336-436-0219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | FCL-001-129
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License Number State | NC
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