Organization
NARU FAMILY CARE HOMES #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK HINES (ADMINISTRATOR)
(336) 972-1892
Entity
Organization
Contact information
Practice address
1425 NE 25TH ST, WINSTON SALEM, NC 27105-5430
(336) 727-1839
Mailing address
PO BOX 1101, WINSTON SALEM, NC 27102-1101
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
FCL034071
NC
Other
Enumeration date
02/27/2007
Last updated
08/30/2007
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