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General NPI Number Information
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NPI Number | 1578766481
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Entity Type | Organization
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Legal Business Name | DAVIS FAMILY CARE HOME
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 408 MIMOSA ST
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City | OXFORD
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State | NC
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Zip | 27565-3535
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Country | US
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Telephone | 919-339-3303
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Fax | 919-603-9644
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Provider Business Mailing Address
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Address Line | 408 MIMOSA ST
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City | OXFORD
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State | NC
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Zip | 27565-3535
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Country | US
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Telephone | 919-339-3303
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Fax | 919-603-9644
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. DOMINICA N DAVIS
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Credential |
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Telephone | 919-339-3303
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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 |
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License Number State |
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