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General NPI Number Information
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NPI Number | 1598266025
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Entity Type | Organization
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Legal Business Name | KARON'S FAMILY CARE HOME
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 570 OAK TREE RD
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City | WILLARD
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State | NC
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Zip | 28478-7655
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Country | US
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Telephone | 910-285-3246
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Fax | 910-285-6969
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Provider Business Mailing Address
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Address Line | 570 OAK TREE RD
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City | WILLARD
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State | NC
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Zip | 28478-7655
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Country | US
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Telephone | 910-285-3246
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Fax | 910-285-6969
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | KARON BRICE
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Credential |
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Telephone | 910-285-3246
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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 | FCL071006
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License Number State | NC
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