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General NPI Number Information
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NPI Number | 1508291063
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Entity Type | Organization
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Legal Business Name | C BREEZE FAMILY CARE CENTER
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 2463 N CHURCH ST TRLR 39
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City | BURLINGTON
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State | NC
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Zip | 27217-3257
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Country | US
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Telephone | 336-350-1503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4174
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City | BURLINGTON
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State | NC
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Zip | 27215-0902
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Country | US
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Telephone | 336-350-1503
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CRYSTAL W STEWART-BREEZE
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Credential |
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Telephone | 336-350-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC3206
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License Number State | NC
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