Organization
LEAK'S FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRINFORD LEAK SR. (OWNER)
(919) 774-6662
Entity
Organization
Contact information
Practice address
302 STONE ST, SANFORD, NC 27330-5831
(919) 777-9146
Mailing address
811 HILLWOOD ST, SANFORD, NC 27330-5530
(919) 774-6662
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-053-019
NC
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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