Organization
LILLIAN BROTHERS FAMILY CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BERNADINE SMITH MPA (ADMINISTRATOR)
(757) 310-1430
Entity
Organization
Contact information
Practice address
533 WEIGHT STATION RD, HERTFORD, NC 27944-8562
(252) 264-3185
Mailing address
533 WEIGHT STATION RD, HERTFORD, NC 27944-8562
(252) 264-3185
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
FCL-072-009
NC
311ZA0620X
Adult Care Home Facility
Primary
FCL-072-009
NC
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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