MEDICARE: MINTZ CARE HOMES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	FCH-057-009	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801913132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINTZ CARE HOMES INC.

Provider Business Mailing Address
First Line	:	PO BOX 41
Second Line	:
City	:	MARSHALL
State	:	NC
Zip	:	28753-0041
Country	:	US
Telephone Number	:	828-649-3420
Fax Number	:	828-683-1409

Provider Business Practice Location Address
First Line	:	311 #3 SERPENTINE AVE.
Second Line	:
City	:	HOT SPRINGS
State	:	NC
Zip	:	28743-0311
Country	:	US
Telephone Number	:	828-649-3420
Fax Number	:	828-683-1409

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EDWINA B MINTZ
Credential	:
Telephone Number	:	828-649-3420

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	08/22/2020

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