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General NPI Number Information
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NPI Number | 1780847780
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Entity Type | Organization
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Legal Business Name | DOGWOOD FAMILY CARE HOME
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 840 ROSS ST
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City | BURLINGTON
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State | NC
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Zip | 27217-1651
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Country | US
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Telephone | 336-436-0046
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Fax | 336-436-0069
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Provider Business Mailing Address
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Address Line | 840 ROSS ST
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City | BURLINGTON
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State | NC
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Zip | 27217-1651
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Country | US
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Telephone | 336-436-0046
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Fax | 336-436-0069
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Authorized Official
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Title or Position | SUPERVISOR IN CHARGE
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Name | MS. CHERLYN LASHUNDA CASH
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Credential |
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Telephone | 336-436-0046
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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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