Organization
VINTAGE INN OF WILLIAMSTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY S PIERCE (MANAGING MEMBER)
(336) 595-1075
Entity
Organization
Contact information
Practice address
826 EAST BLVD, HWY 17 N BYPASS, WILLIAMSTON, NC 27892-2785
(252) 792-8311
Mailing address
PO BOX 1487, KERNERSVILLE, NC 27285-1487
(336) 595-1075
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-058-007
NC
311500000X
Alzheimer Center (Dementia Center)
HAL-058-007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804486
—
NC
Enumeration date
10/26/2006
Last updated
09/11/2025
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