Organization
BRADFORD VILLAGE OF KERNERSVILLE EAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD F MCMANUS (MANAGING MEMBER)
(704) 996-7443
Entity
Organization
Contact information
Practice address
413 N MAIN ST, KERNERSVILLE, NC 27284-2643
(336) 993-4696
Mailing address
PO BOX 1487, KERNERSVILLE, NC 27285-1487
(336) 595-1075
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-034-068
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804975
—
NC
Enumeration date
10/25/2006
Last updated
08/22/2020
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