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General NPI Number Information
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NPI Number | 1346361094
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Entity Type | Organization
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Legal Business Name | WESTDALE MANOR, INCORPORATED
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 303 WESTDALE PL
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City | GREENSBORO
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State | NC
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Zip | 27403-1473
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Country | US
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Telephone | 336-273-7912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21693
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City | GREENSBORO
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State | NC
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Zip | 27420-1693
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Country | US
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Telephone | 336-273-7912
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Fax | 336-275-5696
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMMA ALLEN
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Credential |
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Telephone | 336-558-8411
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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 | FCL-041-027
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License Number State | NC
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