Organization
CAROL LEE FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN CONVERSE (OWNER)
(336) 622-3002
Entity
Organization
Contact information
Practice address
319 E RALEIGH AVE, LIBERTY, NC 27298-3304
(336) 622-3002
Mailing address
319 E RALEIGH AVE, LIBERTY, NC 27298-3304
(336) 622-3002
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-076-021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803999
—
NC
Enumeration date
04/05/2007
Last updated
08/22/2020
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