Organization
COUNTRY MANOR REST HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH UPCHURCH (OWNER)
(336) 498-2353
Entity
Organization
Contact information
Practice address
2061 MILLBORO RD, FRANKLINVILLE, NC 27248-8219
(336) 498-5353
(336) 498-5972
Mailing address
PO BOX 281, RANDLEMAN, NC 27317-0281
(336) 498-2353
(336) 498-5972
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL076002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803803
—
NC
Enumeration date
02/13/2007
Last updated
08/22/2020
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