Organization
JEANNE CULP MOORE
Active
Other names
Forever Young Retreat
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE CULP MOORE (OWNER-ADMINISTRATOR)
(704) 422-6530
Entity
Organization
Contact information
Practice address
44913 BYRD RD, ALBEMARLE, NC 28001-7876
(704) 422-6530
(704) 422-5221
Mailing address
44913 BYRD RD, ALBEMARLE, NC 28001-7876
(704) 422-5221
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-084-002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803511
—
NC
Enumeration date
01/18/2007
Last updated
06/17/2008
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