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Organization
EXTENDED CARE OF THE TRIAD LLC
Active
Organization
EXTENDED CARE OF THE TRIAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM LEA BASS CNA (OWNER PRESIDENT)
(336) 687-9220
Entity
Organization
Contact information
Practice address
313 TRINDALE RD # A, STE 203, ARCHDALE, NC 27263-3800
(336) 861-6826
Mailing address
313 A TRINDALE RD, STE 203, ARCHDALE, NC 27263
(336) 861-6826
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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