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General NPI Number Information
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NPI Number | 1972642049
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Entity Type | Organization
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Legal Business Name | WOODLAWN HAVEN, INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 CRAIG ST
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1265
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Country | US
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Telephone | 704-827-1573
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Fax | 704-827-5705
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Provider Business Mailing Address
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Address Line | 301 CRAIG ST
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1265
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Country | US
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Telephone | 704-827-1573
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Fax | 704-827-5705
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NORMA JEAN LESTER
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Credential |
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Telephone | 704-827-1573
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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 | HAL036006
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License Number State | NC
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