# ENTERPRISE HEALTHCARE OF STATESVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jurney's of Statesville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417071457
- **Authorized official:** EDWARD ELLER (CONTROLLER)
- **Authorized official phone:** (336) 998-5001

## Contact information

- **Practice address:** 1942 VAN HAVEN DR, STATESVILLE, NC 28625-4365
- **Practice address phone:** (704) 878-0046
- **Practice address fax:** (704) 878-9757
- **Mailing address:** PO BOX 1678, CLEMMONS, NC 27012-1678
- **Mailing address phone:** (336) 998-5001
- **Mailing address fax:** (336) 998-5470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL-049-015 | NC | Yes |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7803811 | — | NC |