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Organization
GAVIN & DOWNEY HEAVENLY LIVING HOME #3
Active
Organization
GAVIN & DOWNEY HEAVENLY LIVING HOME #3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN LOIS GAVIN OWNER (OWNER)
(252) 456-9996
Entity
Organization
Contact information
Practice address
426 ROOKER DAIRY RD, NORLINA, NC 27563-9544
(252) 456-9996
(252) 456-2027
Mailing address
545 ROOKER DAIRY RD, NORLINA, NC 27563-9545
(252) 456-2998
(252) 456-2027
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-093-055
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805804
—
NC
Enumeration date
06/11/2010
Last updated
06/11/2010
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