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Organization

CANAAN CARE HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL K GATABAKI (ADMINISTRATOR)
(919) 467-4574
Entity
Organization

Contact information

Practice address
429/431 WALDO ST, CARY, NC 27511-3539
(919) 467-4574
Mailing address
429/431 WALDO ST, CARY, NC 27511-3539
(919) 467-4574

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
MHL-092-546
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418344
NC
05
7805331
NC
05
7805760
NC
Enumeration date
01/25/2007
Last updated
03/01/2013
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