Organization
WADIN CREEK FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILDRED KATHRYN HARRIS (ADMINISTRATOR)
(252) 728-6525
Entity
Organization
Contact information
Practice address
819 HWY 101, BEAUFORT, NC 28516-7718
(252) 728-6525
(252) 728-2801
Mailing address
819 HWY 101, BEAUFORT, NC 28516-7718
(252) 728-6525
(252) 728-2801
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL016-005
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78011816
—
NC
Enumeration date
06/23/2008
Last updated
06/23/2008
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