Organization
THE VILLAGE OF KINSTON ASSISTED LIVING 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
1935 IDLEWILD DR, KINSTON, NC 28504-7148
(252) 208-7103
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-054-067
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7806553
—
NC
Enumeration date
04/27/2009
Last updated
06/13/2013
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