Organization
SKILL CREATIONS OF KENANSVILLE
Active
Parent organization
SKILL CREATIONS INCORPORATED
Organization subpart
Yes
Provider details
NPI number
Legal business name
SKILL CREATIONS INCORPORATED
Authorized official
PAUL HACKMANN (CEO)
(919) 734-7398
Entity
Organization
Contact information
Practice address
218 S STOKES STREET, KENANSVILLE, NC 28349-0001
(910) 296-0078
Mailing address
PO BOX 1636, GOLDSBORO, NC 27533-1636
(919) 734-7398
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
MHL-031-004
NC
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-031-004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406370
—
NC
Enumeration date
09/26/2012
Last updated
01/18/2019
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