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Organization

STANLEY TOTAL LIVING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER DEFELICE RN (ADMINISTRATOR)
(704) 263-1986
Entity
Organization

Contact information

Practice address
514 OLD MOUNT HOLLY RD, STANLEY, NC 28164-2191
(704) 263-1986
(704) 263-8959
Mailing address
514 OLD MOUNT HOLLY RD, P O BOX 489, STANLEY, NC 28164-2191
(704) 263-1986
(704) 263-8959

Taxonomy

Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
NH0386
NC
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0386
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3406382
NC
Enumeration date
12/21/2007
Last updated
11/19/2009
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