# FAIR HAVEN OF FOREST CITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAIR HAVEN OF FOREST CITY LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770995094
- **Authorized official:** MR. JOHN J CILONE (CFO)
- **Authorized official phone:** (828) 245-9095

## Contact information

- **Practice address:** 830 BETHANY CHURCH RD, FOREST CITY, NC 28043-8106
- **Practice address phone:** (828) 245-2852
- **Practice address fax:** (828) 248-2590
- **Mailing address:** 149 FAIRHAVEN DR, BOSTIC, NC 28018-8759
- **Mailing address phone:** (828) 245-9095
- **Mailing address fax:** (828) 245-7856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | NH0474 | NC | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2014
- **Last updated:** 01/14/2016