Organization
COMMUNITY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HAZEL J SPRUILL (OWENER)
(336) 350-2690
Entity
Organization
Contact information
Practice address
1104 S CHURCH ST, BURLINGTON, NC 27215-5048
(336) 350-8295
Mailing address
1104 S CHURCH ST, BURLINGTON, NC 27215-5048
(336) 350-8295
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-001-162
NC
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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