Organization
CANAAN CARE HOME, LLC
Active
Organization
CANAAN CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL K. GATABAKI (ADMINISTRATOR)
(919) 556-4980
Entity
Organization
Contact information
Practice address
2804 STIRRUP CT, WAKE FOREST, NC 27587-6746
(919) 556-4980
(919) 556-4980
Mailing address
2804 STIRRUP CT, WAKE FOREST, NC 27587-6746
(919) 556-4980
(919) 556-4980
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
MHL-092-677
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805760
—
NC
Enumeration date
03/15/2007
Last updated
02/26/2013
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