Organization
KINGS MOUNTAIN CARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE CROCKER (MANAGER)
(704) 739-5929
Entity
Organization
Contact information
Practice address
115 FERGUSON DR, KINGS MOUNTAIN, NC 28086-9727
(704) 739-5929
Mailing address
PO BOX 997, KINGS MOUNTAIN, NC 28086-0997
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL 023-031
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805156
—
NC
Enumeration date
03/05/2007
Last updated
08/22/2020
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