Organization
SHOMARI FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE LONG (OWNER)
(336) 694-9994
Entity
Organization
Contact information
Practice address
3879 HODGES DAIRY RD, YANCEYVILLE, NC 27379-8430
(336) 694-9994
Mailing address
PO BOX 1112, YANCEYVILLE, NC 27379-1112
(336) 694-9994
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-017-021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801386
—
NC
Enumeration date
08/27/2007
Last updated
08/27/2007
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