Organization
ANT MARY'S FAMILY CARE #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EULA CONYERS (OWNER)
(919) 344-9903
Entity
Organization
Contact information
Practice address
104 WEST JAMES STREET, ANT MARY'S FAMILY CARE HOME #1, LAGRANGE, NC 28551-3770
(919) 344-9903
Mailing address
104 WEST JAMES ST., ANT MARY'S FAMILY CARE HOME #1, LAGRANGE, NC 28551-3770
(919) 344-9903
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
FCL054065
NC
Other
Enumeration date
04/23/2010
Last updated
05/04/2010
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