Organization
BROOKSTONE HAVEN OF RANDLEMAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DEAN WILSON (MANAGING PARTNER)
(336) 495-2700
Entity
Organization
Contact information
Practice address
501 POINTE SOUTH DR, RANDLEMAN, NC 27317-9503
(336) 495-2800
Mailing address
PO BOX 814, RANDLEMAN, NC 27317-0814
(336) 495-2700
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
HAL-076-034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7806762
—
NC
Enumeration date
02/07/2013
Last updated
06/13/2013
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