Organization
AUTUMN VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA SUSAN AMBROSE (ADMINISTRATOR)
(910) 298-5877
Entity
Organization
Contact information
Practice address
235 N NC 41 HWY, BEULAVILLE, NC 28518-8633
(910) 298-5877
(910) 298-5578
Mailing address
PO BOX 1140, BEULAVILLE, NC 28518-1140
(910) 298-5877
(910) 298-5578
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL-031-014
NC
Other
Enumeration date
04/13/2007
Last updated
08/22/2020
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