Organization
MITCHELL FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLARISSA M. GUNN (ADMINISTOR)
(336) 234-7400
Entity
Organization
Contact information
Practice address
7727 BLANCH RD, BLANCH, NC 27212-9687
(336) 234-7400
Mailing address
7727 BLANCH RD, BLANCH, NC 27212-9687
(336) 234-7400
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
FCL017027
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
946766754L
—
NC
05
—
946766756S
—
NC
Enumeration date
08/25/2007
Last updated
08/25/2007
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