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Organization
CORNELIA NIXON DAVIS, INC.
Active
Organization
CORNELIA NIXON DAVIS, INC.
Active
Parent organization
CORNELIA NIXON DAVIS, INC.
Other names
Davis Health and Wellness at Cambridge Village
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORNELIA NIXON DAVIS, INC.
Authorized official
MR. CHARLES ALLEN LONG (EXECUTIVE DIRECTOR (CEO))
(910) 686-7195
Entity
Organization
Contact information
Practice address
83 CAVALIER DR., 200, WILMINGTON, NC 28405-4444
(910) 319-2111
(910) 686-7592
Mailing address
1011 PORTERS NECK RD, WILMINGTON, NC 28411-9196
(910) 319-2111
(910) 686-7592
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0645
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3405568
—
NC
Enumeration date
11/26/2014
Last updated
09/14/2018
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