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Organization

MARY L CONNOR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARY LOU CONNOR (OWNER-ADMINISTRATOR)
(828) 254-0203
Entity
Organization

Contact information

Practice address
290 DEAVERVIEW RD, ASHEVILLE, NC 28806-1311
(828) 254-0203
(828) 350-8615
Mailing address
290 DEAVERVIEW RD, ASHEVILLE, NC 28806-1311
(828) 254-0203
(828) 350-8615

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-011-026
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7801407
NC
Enumeration date
03/21/2007
Last updated
06/19/2008
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