Organization
DAVIS REST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTIE DAVIS (OWNER)
(336) 275-0627
Entity
Organization
Contact information
Practice address
1514 WOODBRIAR AVE, GREENSBORO, NC 27405-5366
(336) 375-4400
Mailing address
PO BOX 36448, GREENSBORO, NC 27416-6448
(336) 275-0627
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-041-007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801495
—
NC
Enumeration date
03/07/2007
Last updated
10/27/2016
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