# EVERETT FAMILY CARE HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1992903926
- **Authorized official:** MR. KENNITH EDEN GREENE (ADMINISTRATOR)
- **Authorized official phone:** (252) 345-1452

## Contact information

- **Practice address:** 402 BROAD ST, AULANDER, NC 27805
- **Practice address phone:** (252) 345-1452
- **Practice address fax:** (252) 345-1452
- **Mailing address:** PO BOX 749, AULANDER, NC 27805
- **Mailing address phone:** (252) 345-1452
- **Mailing address fax:** (252) 345-1452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FL008010 | NC | Yes |

## Other

- **Enumeration date:** 07/11/2007
- **Last updated:** 07/11/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7803179 | — | NC |