Organization
PULLIAM FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY PULLIAM (ADMINISTRATOR)
(336) 449-5418
Entity
Organization
Contact information
Practice address
809 W MINNEOLA ST, GIBSONVILLE, NC 27249-8880
(336) 449-5418
Mailing address
809 W MINNEOLA ST, GIBSONVILLE, NC 27249-8880
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
041-031
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801204
—
NC
Enumeration date
04/25/2007
Last updated
08/22/2020
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