Organization
AUTUMN CORPORATION
Active
Other names
Village Care of King
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM M. MARSH CPA (VICE PRESIDENT/CFO)
(252) 443-6265
Entity
Organization
Contact information
Practice address
440 INGRAM ROAD EXT., KING, NC 27021
(336) 983-4900
(336) 983-4710
Mailing address
PO BOX 7728, ROCKY MOUNT, NC 27804-0728
(252) 443-6265
(252) 443-2703
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0507
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3405381
—
NC
Enumeration date
12/20/2005
Last updated
05/02/2008
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