Organization
NC DEPARTMENT OF MILITARY AND VETERAN AFFAIRS NC DIVISION OF VET
Active
Other names
NC STATE VETERANS HOME KINSTON
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETHIA N HOLLEY (PROVIDER ENROLLMENT SPECIALIST)
(770) 806-6875
Entity
Organization
Contact information
Practice address
2150 HULL RD, KINSTON, NC 28504-2052
(252) 939-8000
Mailing address
4001 MAIL SERVICE CTR, RALEIGH, NC 27699-4001
(984) 204-2982
(984) 204-8344
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NC0634
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NH0634
STATE OF NORTH CAROLINA LICENSURE
NC
Enumeration date
03/18/2013
Last updated
09/23/2025
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