Organization
CORNELIA NIXON DAVIS, INC.
Active
Other names
Champions Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ALLEN LONG (EXECUTIVE DIRECTOR)
(910) 686-7195
Entity
Organization
Contact information
Practice address
1007 PORTERS NECK RD, WILMINGTON, NC 28411-7383
(910) 686-6462
(910) 686-8320
Mailing address
1007 PORTERS NECK RD, WILMINGTON, NC 28411-7383
(910) 686-6462
(910) 686-8320
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL065020
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804910
—
NC
Enumeration date
06/17/2005
Last updated
08/22/2020
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