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General NPI Number Information
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NPI Number | 1588800551
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Entity Type | Organization
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Legal Business Name | WNC ASSISTED LIVING
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 159 AMBLE LN
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City | FLETCHER
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State | NC
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Zip | 28732-9555
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Country | US
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Telephone | 828-687-8388
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Fax |
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Provider Business Mailing Address
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Address Line | 80 FORGE VALLEY DR
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City | MILLS RIVER
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State | NC
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Zip | 28759-8600
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Country | US
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Telephone | 828-890-8355
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Fax | 828-651-9169
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MS. THERESA TYREE
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Credential | RN
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Telephone | 828-606-0248
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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 | FCL-045-097
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License Number State | NC
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