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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