Organization
LONG ACRES FAMILY CARE HOME#1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANSFORD NYLANDER THOMPSON (PRESIDENT)
(919) 795-8338
Entity
Organization
Contact information
Practice address
400 PARNELL DR, RALEIGH, NC 27610-3402
(919) 231-7500
Mailing address
1133 VILLA GREEN CT, RALEIGH, NC 27612-2488
(910) 676-8062
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
FCL-092-025
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802070
—
NC
Enumeration date
02/13/2007
Last updated
08/22/2020
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