Organization
GREEN MANOR REST HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZEDDIE BEEBE GREEN (PRESIDENT)
(910) 858-3826
Entity
Organization
Contact information
Practice address
1083 WEST PARKTON TOBEMORY ROAD, PARKTON, NC 28371
(910) 858-3005
Mailing address
PO BOX 299, PARKTON, NC 28371-0299
(910) 858-3826
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-078-003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801957
—
NC
Enumeration date
12/24/2007
Last updated
12/24/2007
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