Organization
COMMONWOOD HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA P. WALKER (OWNER)
(828) 453-0367
Entity
Organization
Contact information
Practice address
348 LEONARD LANE, ELLENBORO, NC 28040
(828) 453-0367
Mailing address
348 LEONARD LANE, ELLENBORO, NC 28040
(828) 453-0367
(828) 453-0367
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL-081-026
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804158
—
NC
Enumeration date
12/12/2007
Last updated
07/12/2011
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