Organization
THE CREST OF CLEMMONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANDORA GEORGE (PRESIDENT)
(336) 766-8050
Entity
Organization
Contact information
Practice address
6010 MEADOWBROOK MALL CT, CLEMMONS, NC 27012-9266
(336) 766-8050
(336) 766-8054
Mailing address
6010 MEADOWBROOK MALL CT, CLEMMONS, NC 27012-9266
(336) 766-8050
(336) 766-8054
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-034-082
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805776
—
NC
Enumeration date
05/22/2007
Last updated
07/09/2008
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