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Organization
GREENSBORO LIVING CENTER, LLC
Active
Organization
GREENSBORO LIVING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH R HODGES (MANAGER)
(828) 738-3053
Entity
Organization
Contact information
Practice address
3004 DEXTER AVE, GREENSBORO, NC 27407-3616
(336) 292-1349
(336) 292-1306
Mailing address
495 ZION HILL RD, MARION, NC 28752-6304
(828) 738-3053
(828) 738-0350
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL041061
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAL041061
LICENSE
NC
Enumeration date
12/31/2007
Last updated
12/31/2007
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