Organization
SENIOR CITIZENS HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN DAVIS III (ADMINISTRATOR)
(252) 492-0066
Entity
Organization
Contact information
Practice address
2275 RUIN CREEK RD, HENDERSON, NC 27537-8732
(252) 492-0066
Mailing address
2275 RUIN CREEK RD, HENDERSON, NC 27537-8732
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
NH0477
NC
313M00000X
Nursing Facility/Intermediate Care Facility
NH0477
NC
314000000X
Skilled Nursing Facility
Primary
NH0477
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3405316
—
NC
05
—
3406558
—
NC
05
—
7801016
—
NC
Enumeration date
10/11/2005
Last updated
06/19/2008
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