Organization
JEFFERSON FAMILY CARE HOME #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA JEFFERSON (OWNER)
(336) 421-9468
Entity
Organization
Contact information
Practice address
181 STALEY BOSWELL RD, YANCEYVILLE, NC 27379-8386
(336) 421-9468
(336) 421-5726
Mailing address
181 STALEY BOSWELL RD, YANCEYVILLE, NC 27379-8386
(336) 421-9468
(336) 421-5726
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802011
—
NC
Enumeration date
03/29/2007
Last updated
08/22/2020
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