Organization
ANGELS FAMILY CARE HOME #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J GRAVES (OWNER)
(336) 222-9297
Entity
Organization
Contact information
Practice address
210 UNION AVE, BURLINGTON, NC 27217-2442
(336) 570-5770
(336) 228-9376
Mailing address
210 UNION AVE, BURLINGTON, NC 27217-2442
(336) 570-5770
(336) 228-9376
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
MHL-001-113
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804934
—
NC
Enumeration date
03/26/2007
Last updated
08/22/2020
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