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Organization

LUMBERTON RETIREMENT COMMUNITY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID DEAN WILSON (MANAGING MEMBER)
(336) 495-2700
Entity
Organization

Contact information

Practice address
550 BAILEY RD, LUMBERTON, NC 28358-2424
(910) 738-7281
Mailing address
PO BOX 814, RANDLEMAN, NC 27317-0814
(336) 495-2700
(336) 495-5552

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
311ZA0620X
Adult Care Home Facility
HAL-078-084
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7806432
NC
Enumeration date
02/05/2009
Last updated
06/13/2013
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