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General NPI Number Information
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NPI Number | 1841623873
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Entity Type | Organization
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Legal Business Name | BLACKNALL FELTON GROUP
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 222 CONNARISTA RD
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City | KELFORD
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State | NC
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Zip | 27847-9602
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Country | US
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Telephone | 252-348-8840
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Fax | 252-348-8840
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Provider Business Mailing Address
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Address Line | 222 CONNARISTA RD
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City | KELFORD
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State | NC
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Zip | 27847-9602
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Country | US
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Telephone | 252-348-8840
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Fax | 252-348-8840
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICIA W GREENE
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Credential |
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Telephone | 252-348-8840
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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 | 008038
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License Number State | NC
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