# KINGS MOUNTAIN MEMORY CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KINGS MOUNTAIN MEMORY CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033343157
- **Authorized official:** PATRICIA ODEGUA ADELEKUN RN, MBA (PRESIDENT)
- **Authorized official phone:** (704) 718-2327

## Contact information

- **Practice address:** 115 FERGUSON DR, KINGS MOUNTAIN, NC 28086-9727
- **Practice address phone:** (704) 739-5929
- **Practice address fax:** (704) 739-1103
- **Mailing address:** PO BOX 1873, KINGS MOUNTAIN, NC 28086-1873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2009
- **Last updated:** 09/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7801288 | — | NC |