Organization
CEDAR GROVE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LEE HAVERI (ADMINISTRATOR)
(919) 580-6280
Entity
Organization
Contact information
Practice address
500 FREE GOSPEL RD, SNOW HILL, NC 28580-8710
(252) 747-3504
(919) 580-9733
Mailing address
101 DAVELIN PL, GOLDSBORO, NC 27530-4507
(919) 580-9733
(919) 580-9733
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL040005
NC
Other
Enumeration date
02/14/2007
Last updated
08/22/2020
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