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Organization

DARRELLE E GREEN

Active
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Organization

DARRELLE E GREEN

Active
Other names
Green Manor Rest Home
Organization subpart
No

Provider details

NPI number
Authorized official
DARRELLE E GREEN (OWNER/OPERATOR)
(910) 858-3826
Entity
Organization

Contact information

Practice address
1165 W PARKTON TOBEMORY RD, PARKTON, NC 28371-0299
(910) 858-3826
Mailing address
PO BOX 597, PARKTON, NC 28371-0597
(910) 858-3826
(910) 858-3005

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-078-090
NC

Other

Enumeration date
09/21/2012
Last updated
09/21/2012
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