Organization
NCAL- MOCKVILLE, INC.
Active
Other names
Somerset Court of Mocksville
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BENTON (CEO)
(336) 724-1000
Entity
Organization
Contact information
Practice address
150 KEN DWIGGINS DR, MOCKSVILLE, NC 27028-2439
(336) 751-1209
(336) 751-0601
Mailing address
1105 BROOKSTOWN AVE, WINSTON SALEM, NC 27101-2524
(336) 724-1000
(336) 724-9955
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL-030-004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805398
—
NC
Enumeration date
12/27/2006
Last updated
11/08/2013
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