Organization
GAVIN & DOWNEY HEAVENLY LIVING HOME 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN LOIS GAVIN (OWNER)
(252) 456-9996
Entity
Organization
Contact information
Practice address
426 ROOKER DAIRY RD, NORLINA, NC 27563-9544
(252) 456-9996
(252) 456-2027
Mailing address
426 ROOKER DAIRY RD, NORLINA, NC 27563-9544
(252) 456-9996
(252) 456-2027
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-093-036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805804
—
NC
Enumeration date
07/05/2007
Last updated
08/28/2007
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