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General NPI Number Information
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NPI Number | 1932405115
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Entity Type | Organization
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Legal Business Name | GRAVES FAMILY CARE
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 409 MILL ST
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City | GRAHAM
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State | NC
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Zip | 27253-2226
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Country | US
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Telephone | 336-214-1257
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Fax | 336-222-6078
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Provider Business Mailing Address
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Address Line | 409 MILL ST
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City | GRAHAM
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State | NC
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Zip | 27253-2226
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Country | US
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Telephone | 336-214-1257
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Fax | 336-222-6078
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ORBRA T. GRAVES JR.
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Credential |
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Telephone | 336-222-1462
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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 | FCL001014
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License Number State | NC
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