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Organization

DIXIE REST HOME 1

Active
Other names
Woodhaven Rest Home 1
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD W WOOD PRESIDENT (ADMINISTRATOR)
(252) 445-5665
Entity
Organization

Contact information

Practice address
310 NORTH MARTIN LUTHER KING AVENUE, ENFIELD, NC 27823
(252) 445-5665
(252) 445-3466
Mailing address
PO BOX 129, 310 NORTH MARTIN LUTHER KING AVENUE, ENFIELD, NC 27823
(252) 445-5665
(252) 445-3466

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL042002
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7801459
NC
Enumeration date
11/13/2006
Last updated
08/22/2020
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