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General NPI Number Information
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NPI Number | 1699332569
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Entity Type | Organization
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Legal Business Name | REDEEMED FCH OF HENDERSONVILLE LLC
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Dates
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Enumeration Date | 05/25/2019
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Last Update Date | 05/25/2019
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Provider Practice Location Address
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Address Line | 1310 HEBRON RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-5181
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Country | US
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Telephone | 828-206-2324
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Fax | 828-505-4919
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Provider Business Mailing Address
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Address Line | PO BOX 1406
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City | LEICESTER
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State | NC
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Zip | 28748-1406
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Country | US
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Telephone | 828-206-2324
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Fax | 828-505-4919
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TERESA WAYNETTE SURRETT
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Credential |
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Telephone | 828-206-2324
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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 |
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License Number State |
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