Organization
HEAVENLY TOUCH CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARCHIE CROCKER (OWNER)
(704) 739-6429
Entity
Organization
Contact information
Practice address
429 CROCKER RD, KINGS MOUNTAIN, NC 28086-4004
(704) 739-6429
Mailing address
429 CROCKER RD, KINGS MOUNTAIN, NC 28086-4004
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL 023-010
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801288
—
NC
Enumeration date
03/22/2007
Last updated
07/16/2008
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