Organization
EMANUEL HOUSE ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKITA BLAKENEY (OWNER/ADMINISTRATOR)
(980) 275-0698
Entity
Organization
Contact information
Practice address
1030 ALAMANCE CT, GREENSBORO, NC 27406-3806
(980) 275-0698
Mailing address
2008 INDIA HOOK RD, ROCK HILL, SC 29732-1220
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-041-076
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FCL-041-076
—
NC
Enumeration date
01/03/2012
Last updated
03/12/2012
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