Organization
GRANTHAM FAMILY CARE HOME 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH E GRANTHAM (OWNER)
(919) 734-1848
Entity
Organization
Contact information
Practice address
642 DITCHBANK RD, GOLDSBORO, NC 27534-4842
(919) 734-1848
Mailing address
301 SOUTH JOHN ST, GOLDSBORO, NC 27530-4842
(919) 734-1848
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
FCL096018
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803932
—
NC
Enumeration date
12/20/2007
Last updated
06/26/2008
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