# ANNIE L LONG

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shomari Family Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154450591
- **Authorized official:** MRS. ANNIE L LONG (OWNER)
- **Authorized official phone:** (336) 694-9994

## Contact information

- **Practice address:** 3879 HODGES DAIRY RD, YANCEYVILLE, NC 27379-8430
- **Practice address phone:** (336) 694-9994
- **Practice address fax:** (336) 694-1107
- **Mailing address:** PO BOX 1112, YANCEYVILLE, NC 27379-1112
- **Mailing address phone:** (336) 694-9994
- **Mailing address fax:** (336) 694-1107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL017021 | NC | Yes |

## Other

- **Enumeration date:** 03/03/2007
- **Last updated:** 08/17/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7801386 | — | NC |