Organization
EDENTON HOUSE, LLC
Active
Other names
Edenton House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES E TREFZGER JR. (MANAGER)
(828) 322-5535
Entity
Organization
Contact information
Practice address
323 MEDICAL ARTS DRIVE, EDENTON, NC 27932
(252) 482-1113
Mailing address
1978 8TH AVE NW, HICKORY, NC 28601-3312
(828) 322-5535
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-021-006
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805865
—
NC
Enumeration date
07/19/2007
Last updated
10/15/2007
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