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Organization

TONYA CLARK FREEMAN

Active
Other names
The Home Place
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA C FREEMAN (OWNER/ADMINISTRATOR)
(252) 642-2665
Entity
Organization

Contact information

Practice address
404 W RIVER ST, COLERAIN, NC 27924-8879
(252) 356-9954
Mailing address
404 W RIVER ST, COLERAIN, NC 27924-8879
(252) 356-9954

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL008043
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FCL008043
DHHS FAMILY CARE HOME LICENSE
NC
Enumeration date
06/22/2018
Last updated
11/21/2024
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