Organization
GLENCARE OF BLADENBORO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIAN ANNE KORNEGAY (VICE PRESIDENT)
(910) 275-0058
Entity
Organization
Contact information
Practice address
714 EAST BLADEN STREET, BLADENBORO, NC 28320
(910) 863-4500
(910) 863-3142
Mailing address
PO BOX 339, KENANSVILLE, NC 28349-0339
(910) 275-0058
(910) 275-0093
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
04/20/2008
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