Organization
COVENTRY HOUSE OF ZEBULON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAVONDA TART (EXECUTIVE DIRECTOR)
(919) 269-7762
Entity
Organization
Contact information
Practice address
1225 W GANNON AVE, ZEBULON, NC 27597-8838
(919) 269-7762
Mailing address
1225 W GANNON AVE, PO BOX 888, ZEBULON, NC 27597-8838
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-092-115
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7805473
PROVIDER NUMBER
NC
Enumeration date
01/05/2007
Last updated
01/02/2008
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