Organization
AUTUMN CORPORATION
Active
Other names
Autumn Care of Mocksville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM M. MARSH CPA (VICE PRESIDENT OF FINANCE)
(252) 443-6265
Entity
Organization
Contact information
Practice address
1007 HOWARD ST, MOCKSVILLE, NC 27028-2548
(336) 751-3535
(336) 751-0028
Mailing address
1007 HOWARD ST, MOCKSVILLE, NC 27028-2548
(336) 751-3535
(336) 751-0028
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0221
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406212
—
NC
Enumeration date
03/14/2008
Last updated
03/14/2008
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