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General NPI Number Information
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NPI Number | 1427639335
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Entity Type | Organization
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Legal Business Name | CAROLINAS ALLIANCE FOR RESIDENTIAL EXCELLENCE - STAR, LLC
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 327 FREEMAN ST
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City | STAR
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State | NC
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Zip | 27356-7948
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Country | US
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Telephone | 910-428-9101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 471
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City | NEWLAND
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State | NC
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Zip | 28657-0471
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Country | US
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Telephone | 855-677-1188
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Fax | 855-677-1189
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Authorized Official
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Title or Position | COO
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Name | LAUREN ASHLEY REAVIS-WARE
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Credential | RN
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Telephone | 336-408-5008
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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 |
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License Number State |
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