Organization
C.R.T. GOLDEN LAMB REST HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE DAVIS JR. (CEO)
(336) 727-9119
Entity
Organization
Contact information
Practice address
1515 GOLDEN LAMB CT, WINSTON SALEM, NC 27105-6700
(336) 727-9119
(336) 727-1128
Mailing address
PO BOX 16304, WINSTON SALEM, NC 27115-6304
(336) 727-9119
(336) 727-1128
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-034-019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801856
—
NC
Enumeration date
03/29/2007
Last updated
08/22/2020
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