Organization
SMITH STREET VILLAGE FAMILY CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS B STREET RN (PRESIDENT/ADMINISTRATOR)
(828) 676-5600
Entity
Organization
Contact information
Practice address
234 COUNTRY TIME LN, LEICESTER, NC 28748-6213
(828) 676-5600
Mailing address
PO BOX 889, MOUNTAIN HOME, NC 28758-0889
(828) 676-5600
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
06/30/2015
Last updated
07/14/2015
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