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Organization
BEATRICE PETWAY
Active
Organization
BEATRICE PETWAY
Active
Other names
YOUR LOVING FAMILY CARE HOME 1
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRICE PETWAY (OWNER)
(252) 813-5960
Entity
Organization
Contact information
Practice address
730 MARIGOLD ST, ROCKY MOUNT, NC 27801-5908
(252) 446-5559
(252) 446-5560
Mailing address
730 MARIGOLD ST, ROCKY MOUNT, NC 27801-5908
(252) 446-5559
(252) 442-1147
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL033006
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804834
—
NC
Enumeration date
02/21/2007
Last updated
09/19/2023
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