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General NPI Number Information
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NPI Number | 1679801898
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Entity Type | Organization
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Legal Business Name | PEAR MANOR
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Dates
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Enumeration Date | 11/29/2009
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Last Update Date | 11/29/2009
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Provider Practice Location Address
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Address Line | 2521 PEAR ST
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City | GREENSBORO
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State | NC
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Zip | 27401-4048
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Country | US
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Telephone | 336-617-7485
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Fax |
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Provider Business Mailing Address
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Address Line | 3210 OLIVER DR
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City | GREENSBORO
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State | NC
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Zip | 27406-9289
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Country | US
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Telephone | 336-558-8411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. AMMA ALLEN
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Credential |
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Telephone | 336-558-8411
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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 | FCL-041-067
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License Number State | NC
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