Organization
CHAVIS MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIRDRE LEA MILTON (OWNER)
(336) 437-5873
Entity
Organization
Contact information
Practice address
204 CIRCLE DR, GIBSONVILLE, NC 27249-2310
(336) 437-5873
Mailing address
204 CIRCLE DR, GIBSONVILLE, NC 27249-2310
(336) 437-5873
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL041-1022
NC
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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