Organization
HOME AWAY FROM HOME FAMILY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA NORMAN (ADMINISTRATOR)
(704) 751-7602
Entity
Organization
Contact information
Practice address
107 BRETT DR, SHELBY, NC 28152-9107
(704) 313-7086
Mailing address
PO BOX 711, SHELBY, NC 28151-0711
(704) 751-7602
(704) 918-1273
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FLC-023-040
NC
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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