Organization
ANNIE L LONG
Active
Other names
Shomari Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNIE L LONG (OWNER)
(336) 694-9994
Entity
Organization
Contact information
Practice address
3879 HODGES DAIRY RD, YANCEYVILLE, NC 27379-8430
(336) 694-9994
(336) 694-1107
Mailing address
PO BOX 1112, YANCEYVILLE, NC 27379-1112
(336) 694-9994
(336) 694-1107
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL017021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801386
—
NC
Enumeration date
03/03/2007
Last updated
08/17/2007
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