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General NPI Number Information
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NPI Number | 1659710416
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Entity Type | Organization
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Legal Business Name | STERLING HOUSE OF ROCKY MOUNT
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 650 GOLDROCK ROAD STERLING HOUSE OF ROCKY MOUNT
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City | ROCKY MOUNT
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State | NC
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Zip | 27804
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Country | US
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Telephone | 252-446-0974
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Fax |
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Provider Business Mailing Address
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Address Line | 650 GOLDROCK RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-8804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DANA C WATERS
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Credential |
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Telephone | 252-446-6005
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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 | HAL064008
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License Number State | NC
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