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General NPI Number Information
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NPI Number | 1881928844
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Entity Type | Organization
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Legal Business Name | ALPHA & OMEGA FAMILY CARE & RETIREMENT CENTER
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 257 HORACE PERRY RD
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City | WARRENTON
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State | NC
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Zip | 27589-8923
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Country | US
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Telephone | 252-257-3095
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Fax | 252-257-3095
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Provider Business Mailing Address
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Address Line | 257 HORACE PERRY RD
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City | WARRENTON
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State | NC
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Zip | 27589-8923
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Country | US
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Telephone | 252-257-3095
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Fax | 252-257-3095
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. RUTH W PERRY
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Credential |
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Telephone | 252-257-3095
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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-093-007
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License Number State | NC
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