# GRAHAM DRIVE FAMILY CARE HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255777256
- **Authorized official:** MISS STELLA KAYE FOWLER (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (336) 228-1525

## Contact information

- **Practice address:** 509 GRAHAM DR, GRAHAM, NC 27253-2119
- **Practice address phone:** (336) 228-1525
- **Practice address fax:** (336) 228-1523
- **Mailing address:** 509 GRAHAM DR, GRAHAM, NC 27253-2119
- **Mailing address phone:** (336) 228-1525
- **Mailing address fax:** (336) 228-1523

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2013
- **Last updated:** 05/16/2013