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General NPI Number Information
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NPI Number | 1649434598
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Entity Type | Organization
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Legal Business Name | THE JANICE MAE HAWKINS FOUNDATION INC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 204 S REILLY RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-0340
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Country | US
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Telephone | 910-864-3426
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Fax | 910-764-1457
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Provider Business Mailing Address
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Address Line | 204 S REILLY RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-0340
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Country | US
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Telephone | 910-864-3426
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Fax | 910-764-1457
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Authorized Official
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Title or Position | ADMINISTRATOR CEO
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Name | MS. SHERYL ANNETTE LYONS
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Credential | RN BSN
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Telephone | 910-864-3426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | HC2410
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | HC2410
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License Number State | NC
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