Organization
BROOKSTONE OF CLEMMONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE D PETERSON (ADMINISTRATOR)
(336) 687-2580
Entity
Organization
Contact information
Practice address
4430 CLINARD RD, CLEMMONS, NC 27012-8487
(336) 766-5000
(336) 766-5020
Mailing address
PO BOX 1682, CLEMMONS, NC 27012-1682
(336) 766-5000
(336) 766-5020
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-034-102
NC
Other
Enumeration date
05/25/2017
Last updated
05/25/2017
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