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General NPI Number Information
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NPI Number | 1669503645
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Entity Type | Organization
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Legal Business Name | OAKWOOD FAMILY CARE HOME
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 511 NC HIGHWAY 87
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City | REIDSVILLE
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State | NC
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Zip | 27320-9725
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Country | US
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Telephone | 336-342-2960
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 202
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City | REIDSVILLE
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State | NC
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Zip | 27323-2020
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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 | ADMINISTRATOR
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Name | MRS. EDITH BLACKWELL
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Credential |
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Telephone | 336-342-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | FCL-079-019
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-079-019
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License Number State | NC
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