# WILLOW MANOR

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

## Provider details

- **NPI number:** 1972999571
- **Authorized official:** COURTNEY BLOUNT (OWNER)
- **Authorized official phone:** (252) 402-5317

## Contact information

- **Practice address:** 4288 US HIGHWAY 17 S, CHOCOWINITY, NC 27817-8434
- **Practice address phone:** (252) 946-2604
- **Mailing address:** 1220 PAMLICO ST, WASHINGTON, NC 27889-3821
- **Mailing address phone:** (252) 402-5317

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL-007-020 | NC | Yes |

## Other

- **Enumeration date:** 04/09/2015
- **Last updated:** 04/09/2015