# C&M ADULT CARE HOME

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

## Provider details

- **NPI number:** 1972630614
- **Authorized official:** CORETTA R. WILSON ALEXANDER (SUPERVISOR IN CHARGE)
- **Authorized official phone:** (336) 227-5216

## Contact information

- **Practice address:** 422 N MAIN ST, BURLINGTON, NC 27217-3908
- **Practice address phone:** (336) 227-5216
- **Mailing address:** 422 N MAIN ST, BURLINGTON, NC 27217-3908
- **Mailing address phone:** (336) 227-5216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-001-089 | NC | Yes |

## Other

- **Enumeration date:** 02/28/2007
- **Last updated:** 06/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7804163 | — | NC |