# JEFFERSON CARE HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1295854933
- **Authorized official:** MRS. MELINDA COX JEFFERSON (OWNER)
- **Authorized official phone:** (336) 421-9468

## Contact information

- **Practice address:** 181 STALEY BOSWELL RD, YANCEYVILLE, NC 27379-8386
- **Practice address phone:** (336) 421-9468
- **Practice address fax:** (336) 421-5726
- **Mailing address:** 181 STALEY BOSWELL RD, YANCEYVILLE, NC 27379-8386
- **Mailing address phone:** (336) 421-9468
- **Mailing address fax:** (336) 421-5726

## Taxonomy

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

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7802009 | — | NC |