Organization
ENTERPRISE HEALTHCARE OF STATESVILLE
Active
Other names
Jurney's of Statesville
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ELLER (CONTROLLER)
(336) 998-5001
Entity
Organization
Contact information
Practice address
1942 VAN HAVEN DR, STATESVILLE, NC 28625-4365
(704) 878-0046
(704) 878-9757
Mailing address
PO BOX 1678, CLEMMONS, NC 27012-1678
(336) 998-5001
(336) 998-5470
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL-049-015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803811
—
NC
Enumeration date
03/16/2007
Last updated
08/22/2020
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