# TI-WILLOW HAVEN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Willow Place
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154409662
- **Authorized official:** MR. JOSEPH C TUTERA (OWNER)
- **Authorized official phone:** (816) 444-0900

## Contact information

- **Practice address:** 1703 STONEWALL RD, LAURINBURG, NC 28352-9706
- **Practice address phone:** (910) 276-9211
- **Practice address fax:** (910) 276-4535
- **Mailing address:** 1703 STONEWALL RD, LAURINBURG, NC 28352-9706
- **Mailing address phone:** (910) 276-9211
- **Mailing address fax:** (910) 276-4535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL083012 | NC | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 01/15/2016