Organization
SOUTHERN SEASONS FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY EVANS (ADMINISTRATOR)
(336) 512-3377
Entity
Organization
Contact information
Practice address
625 LANE ST, BURLINGTON, NC 27217-2473
(336) 229-9900
(336) 229-9900
Mailing address
1703 VAUGHN RD, BURLINGTON, NC 27217-2915
(336) 229-9900
(336) 229-9900
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801979
—
NC
Enumeration date
01/29/2008
Last updated
01/29/2008
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