# BLAIR ASSISTED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902944499
- **Authorized official:** MARLITA MOUJAHED (OWNER)
- **Authorized official phone:** (910) 318-9667

## Contact information

- **Practice address:** 311 N MAIN ST, LAURINBURG, NC 28352-3121
- **Practice address phone:** (910) 318-9667
- **Practice address fax:** (910) 276-9223
- **Mailing address:** PO BOX 2342, LAURINBURG, NC 28353-2342
- **Mailing address phone:** (910) 318-9667
- **Mailing address fax:** (910) 276-9223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-083-008 | NC | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805182 | — | NC |