# BEATRICE PETWAY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** YOUR LOVING FAMILY CARE HOME 1
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962547505
- **Authorized official:** BEATRICE PETWAY (OWNER)
- **Authorized official phone:** (252) 813-5960

## Contact information

- **Practice address:** 730 MARIGOLD ST, ROCKY MOUNT, NC 27801-5908
- **Practice address phone:** (252) 446-5559
- **Practice address fax:** (252) 446-5560
- **Mailing address:** 730 MARIGOLD ST, ROCKY MOUNT, NC 27801-5908
- **Mailing address phone:** (252) 446-5559
- **Mailing address fax:** (252) 442-1147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL033006 | NC | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 09/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7804834 | — | NC |