1346431715 NPI number — L AND N FAMILY CARE HOME INC

Table of content: (NPI 1346431715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346431715 NPI number — L AND N FAMILY CARE HOME INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
L AND N FAMILY CARE HOME 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:
Provider Other Organization Name Type Code:
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:
1346431715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
142 GRASSY KNOB RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDREWS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28901-9222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-321-5898
Provider Business Mailing Address Fax Number:
828-321-0608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
142 GRASSY KNOB RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDREWS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28901-9222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-321-5898
Provider Business Practice Location Address Fax Number:
828-321-0608
Provider Enumeration Date:
08/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STANLEY
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER AND ADMINISTRATOR
Authorized Official Telephone Number:
828-321-5898

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  FCL-020-011 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7804933 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".