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General NPI Number Information
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NPI Number | 1881722668
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Entity Type | Organization
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Legal Business Name | JUNIPER SPRINGS CENTER
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 153 SPRINGS LN
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City | IVANHOE
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State | NC
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Zip | 28447-8905
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Country | US
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Telephone | 910-532-4670
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Fax | 910-532-2423
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Provider Business Mailing Address
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Address Line | 153 SPRINGS LN
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City | IVANHOE
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State | NC
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Zip | 28447-8905
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Country | US
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Telephone | 910-532-4670
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Fax | 910-532-2423
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. HANNAH P. MCKOY
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Credential |
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Telephone | 910-532-4670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL-082-003
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License Number State | NC
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