Organization
CENTRAL LONG TERM CARE FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL PAYNE (ADMINISTRATOR)
(336) 320-2185
Entity
Organization
Contact information
Practice address
139 APEX LN, MOUNT AIRY, NC 27030-5595
(336) 320-2185
(336) 320-2186
Mailing address
139 APEX LN, MOUNT AIRY, NC 27030-5595
(336) 320-2185
(336) 320-2186
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-086-001
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801411
—
NC
Enumeration date
01/18/2007
Last updated
08/22/2020
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