Organization
WILKESBORO LIVIG CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA H WILSON (OFFICE MANAGER)
(828) 738-3053
Entity
Organization
Contact information
Practice address
176 RESTHOME RD, WILKESBORO, NC 28697-7145
(336) 973-3890
(336) 973-3042
Mailing address
495 ZION HILL RD, MARION, NC 28752-6304
(828) 738-3053
(828) 738-0350
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL097012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAL097012
LICENSE
NC
Enumeration date
01/13/2009
Last updated
01/13/2009
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