Organization
TRADITIONAL LIVING HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI R GAUGHAN (OWNER)
(336) 667-4546
Entity
Organization
Contact information
Practice address
101 W MAIN ST, WILKESBORO, NC 28697-2422
(336) 667-4546
(336) 667-2621
Mailing address
1550 OVERLOOK DR, WILKESBORO, NC 28697-2610
(336) 667-6447
(336) 667-2621
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2784
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601897
—
NC
Enumeration date
02/15/2006
Last updated
11/25/2009
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