Organization
ST.MARYS ASSITED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN RENA BENNETT (ADMINISTRATOR)
(910) 843-5461
Entity
Organization
Contact information
Practice address
104 HOPE LANE, RED SPRINGS, NC 28377-9999
(910) 843-5461
(910) 843-2978
Mailing address
PO BOX 706, RED SPRINGS, NC 28377-0706
(910) 843-5461
(910) 843-2978
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL078-052
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805487
—
NC
Enumeration date
04/02/2007
Last updated
08/22/2020
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