Organization
GOOD SHEPHERD FAMILY CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARLENE TOMAS BALASSU-PASCUA BSN, RN (MANAGER)
(336) 644-0752
Entity
Organization
Contact information
Practice address
2810 FLEMING ROAD, GREENSBORO, NC 27410
(336) 644-0752
(336) 643-9731
Mailing address
3592 HANCOCK DR, GREENSBORO, NC 27410-9157
(336) 644-0752
(336) 643-9731
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-041-754
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805363
—
NC
Enumeration date
11/06/2007
Last updated
12/30/2008
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