1730336736 NPI number — WNC FAMILY CARE HOMES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730336736 NPI number — WNC FAMILY CARE HOMES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WNC FAMILY CARE HOMES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WNC FAMILY CARE HOME #10
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730336736
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28816-6220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-254-4840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 COUNTRY TIME LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEICESTER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28748-6213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-254-4840
Provider Business Practice Location Address Fax Number:
828-254-4844
Provider Enumeration Date:
08/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GILLESPIE
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
828-243-7747

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  FCL-011-281 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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