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General NPI Number Information
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NPI Number | 1902094543
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Entity Type | Organization
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Legal Business Name | OUTER BANKS HAVEN, INC.
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 430 W HEALTH CENTER DR
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City | NAGS HEAD
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State | NC
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Zip | 27959-8943
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Country | US
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Telephone | 252-441-3116
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Fax | 252-441-0247
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Provider Business Mailing Address
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Address Line | 430 W HEALTH CENTER DR
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City | NAGS HEAD
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State | NC
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Zip | 27959-8943
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Country | US
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Telephone | 252-441-3116
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Fax | 252-441-0247
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NORWOOD RANDOLPH UZZELL
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Credential |
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Telephone | 252-523-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH0372
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License Number State | NC
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