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Organization
AUTUMN CORPORATION
Active
Organization
AUTUMN CORPORATION
Active
Other names
Autumn Care of Forest City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL M MARSH CPA (VICE PRESIDENT)
(252) 443-6265
Entity
Organization
Contact information
Practice address
830 BETHANY CHURCH RD, FOREST CITY, NC 28043-8106
(828) 245-2852
(828) 248-2590
Mailing address
PO BOX 7728, ROCKY MOUNT, NC 27804-0728
(252) 443-6265
(252) 443-2703
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
NH0474
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803873
—
NC
Enumeration date
07/08/2008
Last updated
07/08/2008
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