Organization
MASONIC AND EASTERN STAR HOME OF NORTH CAROLINA, INCORPORATED
Active
Other names
WhiteStone: A Masonic and Eastern Star Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE JERNIGAN (CHAIRMAN, BOARD OF DIRECTORS)
(336) 299-0031
Entity
Organization
Contact information
Practice address
700 S HOLDEN RD, GREENSBORO, NC 27407-2321
(336) 299-0031
(336) 547-2999
Mailing address
700 S HOLDEN RD, GREENSBORO, NC 27407-2321
(336) 299-0031
(336) 547-2999
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH0141
NC
314000000X
Skilled Nursing Facility
Primary
NH0141
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22871
PARTNERS INSURANCE
NC
05
—
340614P
—
NC
05
—
3415506
—
NC
05
—
7806239
—
NC
Enumeration date
01/25/2006
Last updated
05/22/2014
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