Organization
ELLIOTTE MANOR #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JUNIOUS ELLIOTTE (OWNER/ADMINISTRATOR)
(704) 545-3051
Entity
Organization
Contact information
Practice address
10201 CONNELL RD, MINT HILL, NC 28227-6947
(704) 545-1366
(704) 545-3561
Mailing address
10201 CONNELL RD, MINT HILL, NC 28227-6947
(704) 545-1366
(704) 545-3561
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL060093
NC
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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