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General NPI Number Information
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NPI Number | 1588895288
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Entity Type | Organization
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Legal Business Name | T & S HOMEPLACE
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 1808 CONOVER DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4562
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Country | US
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Telephone | 910-323-3797
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 CEDAR CREEK RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28312-6544
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Country | US
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Telephone | 910-323-3797
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHELBIA NORRIS
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Credential |
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Telephone | 910-323-3797
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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 | MHL026661
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License Number State | NC
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