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Organization
DBG III LLC
Active
Organization
DBG III LLC
Active
Other names
Fair Bluff Assisted Living #1
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID B GOLDSTON III (MANAGER)
(910) 754-6621
Entity
Organization
Contact information
Practice address
225 MINTON ST, FAIR BLUFF, NC 28439-9590
(910) 754-6621
Mailing address
PO BOX 1559, SHALLOTTE, NC 28459-1559
(910) 754-6621
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-024-005
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805470
—
NC
Enumeration date
02/03/2007
Last updated
08/22/2020
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