Organization
MOUNTAIN LIVING ADULT CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER L. GREER (OWNER)
(336) 846-2424
Entity
Organization
Contact information
Practice address
121 BROOK ST, JEFFERSON, NC 28640-9643
(336) 846-2424
(336) 846-2424
Mailing address
121 BROOK ST, P.O. BOX 240, JEFFERSON, NC 28640-9643
(336) 846-2424
(336) 846-2424
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HAL-005-014
NC
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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