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Organization

NELLIES FAMILY CARE HOME INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELL HERNANDEZ (PRESIDENT)
(704) 480-1332
Entity
Organization

Contact information

Practice address
1608 FALLSTON ROAD, SHELBY, NC 28150-4619
(704) 482-0340
Mailing address
1608 FALLSTON RD, SHELBY, NC 28150-3365
(704) 482-0340

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL 023-015
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7804624
NC
05
7804625
NC
Enumeration date
03/28/2007
Last updated
08/21/2012
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