PROVIDENCE HEALTHCARE OF THE CAROLINAS NPI 1497260608

NPI Information

PROVIDENCE HEALTHCARE OF THE CAROLINAS is an assisted living facility in Smithfield, 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. PROVIDENCE HEALTHCARE OF THE CAROLINAS NPI is 1497260608. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Assisted Living.

The provider's business location address is:

4302 HWY NC 210
SMITHFIELD, NC
ZIP 27577

The provider's authorized official is Termaine Moore .
The authorized official title is Executive Director and has the following contact phone number (919) 247-4760.

The CLIA number assigned to this NPI record is 34D2142261 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2017 and was last updated on 12/11/2017.

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:

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