Organization
CLASSIC CARE HOMES 103
Active
Organization
CLASSIC CARE HOMES 103
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE HOLLAMON (ADMINISTRATOR)
(919) 934-8976
Entity
Organization
Contact information
Practice address
103 ANNIE PARKER CIR, SMITHFIELD, NC 27577-3970
(919) 934-8976
(919) 934-8976
Mailing address
101 ANNIE PARKER CIR, SMITHFIELD, NC 27577-3968
(919) 934-8976
(919) 934-8976
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-051-019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803022
—
NC
Enumeration date
01/30/2007
Last updated
08/22/2020
Update your record
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