Organization
HAWTHORN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JEAN DAVENPORT (OWNER)
(252) 209-6986
Entity
Organization
Contact information
Practice address
1025 HWY 45 NORTH, MERRY HILL, NC 27957-9408
(252) 356-4141
Mailing address
1025 HWY 45 NORTH, MERRY HILL, NC 27957
(252) 356-4141
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL 008-025
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FCL-008-025
FAMILY CARE LICENSE NUMBER
NC
Enumeration date
01/02/2009
Last updated
01/02/2009
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