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Organization

STANLEY TOTAL LIVING CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER DEFELICE RN (ADMINISTRATOR)
(704) 263-1986
Entity
Organization

Contact information

Practice address
514 OLD MOUNT HOLLY RD, STANLEY, NC 28164-2191
(704) 263-1986
(704) 263-8959
Mailing address
PO BOX 489, STANLEY, NC 28164-0489
(704) 263-1986
(704) 263-8959

Taxonomy

Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
NH0386
NC
311ZA0620X
Adult Care Home Facility
NH0386
NC
313M00000X
Nursing Facility/Intermediate Care Facility
NH0386
NC
314000000X
Skilled Nursing Facility
Primary
NH0386
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0086C
PROVIDER NUMBER
NC
05
3405264
NC
Enumeration date
09/29/2005
Last updated
11/19/2009
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