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NPI 1790805364

NPI 1790805364 : PLEMMONS FAMILY CARE #2 : CANDLER, NC

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General NPI Number Information
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    NPI Number           |    1790805364
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    Entity Type          |    Organization 
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    Legal Business Name  |    PLEMMONS FAMILY CARE #2 
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Dates
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    Enumeration Date     |    03/29/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    215 MONTE VISTA RD 
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    City                 |    CANDLER
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    State                |    NC
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    Zip                  |    28715-9660
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    Country              |    US
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    Telephone            |    828-776-6776
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 17426 
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    City                 |    ASHEVILLE
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    State                |    NC
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    Zip                  |    28816-7426
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    Country              |    US
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    Telephone            |    828-776-6776
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     SHARON  PLEMMONS 
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    Credential           |    
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    Telephone            |    828-776-6776
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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       |    FCL-011-036
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    License Number State |    NC
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