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Organization
NC DEPARTMENT OF MILITARY AND VETERAN AFFAIRS NC DIVISION OF VET
Active
Organization
NC DEPARTMENT OF MILITARY AND VETERAN AFFAIRS NC DIVISION OF VET
Active
Other names
NC STATE VETERANS HOME KINSTON
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETHIA N HOLLEY (PROVIDER ENROLLMENT SPECIALIST)
(770) 806-6875
Entity
Organization
Contact information
Practice address
2150 HULL RD, KINSTON, NC 28504-2052
(252) 939-8000
Mailing address
4001 MAIL SERVICE CTR, RALEIGH, NC 27699-4001
(984) 204-2982
(984) 204-8344
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NC0634
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NH0634
STATE OF NORTH CAROLINA LICENSURE
NC
Enumeration date
03/18/2013
Last updated
09/23/2025
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