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General NPI Number Information
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NPI Number | 1790966232
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Entity Type | Organization
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Legal Business Name | B & B ASSISTED LIVING 5
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 2133 PRESTON RD
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City | MAXTON
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State | NC
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Zip | 28364-8697
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Country | US
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Telephone | 910-521-7335
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Fax | 910-522-0655
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Provider Business Mailing Address
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Address Line | 2133 PRESTON RD
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City | MAXTON
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State | NC
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Zip | 28364-8697
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Country | US
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Telephone | 910-521-7335
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Fax | 910-522-0655
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS BEVERLY MAYNOR
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Credential |
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Telephone | 910-521-7335
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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 | FCL078096
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License Number State | NC
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