Organization
CAMELOT MANOR INC
Active
Other names
DBA Brockford Inn Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH BARLOW (ADMINISTRATOR/ OWNER)
(828) 396-3111
Entity
Organization
Contact information
Practice address
56 N HIGHLAND AVE, DBA BROCKFORD INN INC, GRANITE FALLS, NC 28630-1205
(828) 396-3111
(828) 396-5822
Mailing address
PO BOX 58, DBA BROCKFORD INN INC, GRANITE FALLS, NC 28630-0058
(828) 396-3111
(828) 396-5822
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-014-014
NC
311500000X
Alzheimer Center (Dementia Center)
HAL-014-014
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600480534
STATE NUMBER
NC
05
—
7805030
—
NC
Enumeration date
09/25/2006
Last updated
07/15/2008
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