# DAVIS REST HOME

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

## Provider details

- **NPI number:** 1487784542
- **Authorized official:** MRS. BETTIE DAVIS (OWNER)
- **Authorized official phone:** (336) 275-0627

## Contact information

- **Practice address:** 1514 WOODBRIAR AVE, GREENSBORO, NC 27405-5366
- **Practice address phone:** (336) 375-4400
- **Mailing address:** PO BOX 36448, GREENSBORO, NC 27416-6448
- **Mailing address phone:** (336) 275-0627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-041-007 | NC | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 10/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7801495 | — | NC |