Organization
MIZPAH HEALTHCARE, INC
Active
Other names
Lake James Lodge Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY CHILDREY R.N. (CEO)
(910) 848-0694
Entity
Organization
Contact information
Practice address
63 LAKEVIEW DR N, MARION, NC 28752-8896
(828) 652-3038
Mailing address
PO BOX 1796, SOUTHERN PINES, NC 28388-1796
(910) 848-0694
(910) 848-0456
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-059-008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802946
—
NC
Enumeration date
02/23/2007
Last updated
08/22/2020
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