Organization
HINES GOOD SAMARITAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARETTA HINES MOORE (ADMINISTRATOR)
(336) 727-1308
Entity
Organization
Contact information
Practice address
2317 ELBON DR, WINSTON SALEM, NC 27105-5649
(336) 722-7818
Mailing address
2224 MANCHESTER ST, WINSTON SALEM, NC 27105-5536
(336) 727-1308
(336) 723-8142
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL034077
NC
Other
Enumeration date
04/28/2008
Last updated
05/05/2008
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