# NCAL- MOCKVILLE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Somerset Court of Mocksville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114082419
- **Authorized official:** WILLIAM BENTON (CEO)
- **Authorized official phone:** (336) 724-1000

## Contact information

- **Practice address:** 150 KEN DWIGGINS DR, MOCKSVILLE, NC 27028-2439
- **Practice address phone:** (336) 751-1209
- **Practice address fax:** (336) 751-0601
- **Mailing address:** 1105 BROOKSTOWN AVE, WINSTON SALEM, NC 27101-2524
- **Mailing address phone:** (336) 724-1000
- **Mailing address fax:** (336) 724-9955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL-030-004 | NC | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 11/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805398 | — | NC |