LESLIE EVELYN TODD OAK GROVE FAMILY CARE NPI 1073796264

NPI Information

NPI: 1073796264
Provider Name: LESLIE EVELYN TODD OAK GROVE FAMILY CARE

Other Name: OAK GROVE FAMILY CARE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
583 SASSAFRAS RD
ROUTE 4 BOX 271
BLADENBORO, NC
ZIP 28320
Phone: (910) 648-2176
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LESLIE EVELYN TODD OAK GROVE FAMILY CARE is an assisted living facility in Bladenboro, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. LESLIE EVELYN TODD OAK GROVE FAMILY CARE NPI is 1073796264. The provider is registered as an organization entity type.
The provider Other Name Is Oak Grove Family Care.

The provider's business location address is:

583 SASSAFRAS RD
ROUTE 4 BOX 271
BLADENBORO, NC
ZIP 28320-925
Phone: (910) 648-2176
Fax: (910) 648-5785

The provider's authorized official is Andrea Callihan Dove .
The authorized official title is Administrator and has the following contact phone number (910) 648-2176.

The enumeration date for this NPI number is 12/11/2007 and was last updated on 6/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		FCL-009-008	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7802347	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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