Organization
OAK GROVE FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN TODD (OWNER)
(910) 648-2176
Entity
Organization
Contact information
Practice address
583 SASSAFRAS RD, BLADENBORO, NC 28320-5925
(910) 648-2176
Mailing address
583 SASSAFRAS RD, BLADENBORO, NC 28320-5925
(910) 648-2176
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
FCH009008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802347
—
NC
Enumeration date
12/20/2007
Last updated
12/20/2007
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