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Organization

ST ANDREWS LIVING CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT E UNDERWOOD JR. (OWNER)
(704) 788-1018
Entity
Organization

Contact information

Practice address
246 CABARRUS AVE W, CONCORD, NC 28025-5152
(704) 788-1018
Mailing address
PO BOX 143, CONCORD, NC 28026-0143
(704) 788-1018

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-013-006
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7801828
NC
Enumeration date
08/21/2006
Last updated
08/22/2020
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