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General NPI Number Information
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NPI Number | 1881059319
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Entity Type | Organization
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Legal Business Name | CLARA'S COTTAGES, INC.
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 5820 HOLLAND ST
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City | MORGANTON
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State | NC
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Zip | 28655-7931
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Country | US
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Telephone | 828-391-1929
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Fax | 828-391-1929
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Provider Business Mailing Address
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Address Line | 5820 HOLLAND ST
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City | MORGANTON
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State | NC
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Zip | 28655-7931
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Country | US
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Telephone | 828-391-1929
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Fax | 828-391-1929
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIEL CHARLES WALKER
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Credential | OWNER
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Telephone | 828-448-5831
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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-012-043
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-012-042
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License Number State | NC
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