Organization
AUTUMN CORPORATION
Active
Other names
Autumn Care of Raeford
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM M MARSH CPA (VICE PRESIDENT)
(252) 443-6265
Entity
Organization
Contact information
Practice address
1206 N FULTON ST, RAEFORD, NC 28376-1926
(910) 875-4280
(910) 875-7059
Mailing address
PO BOX 7728, ROCKY MOUNT, NC 27804-0728
(252) 443-6265
(252) 443-2703
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0438
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406428
—
NC
Enumeration date
04/18/2008
Last updated
04/18/2008
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