MR. ESTELLA JOANN SPANN NPI 1639823784

NPI Information

NPI: 1639823784
Provider Name: MR. ESTELLA JOANN SPANN
Classification: Assisted Living Facility - 310400000X
Entity Type: Individual
Address:
1136 BERTHA WILSON RD
BLANCH, NC
ZIP 27212
Phone: (336) 694-1878
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MR. Estella Joann Spann is an assisted living facility in Blanch, 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. MR. Estella Joann Spann NPI is 1639823784. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1136 BERTHA WILSON RD
BLANCH, NC
ZIP 27212-795
Phone: (336) 694-1878
Fax: (336) 694-1878

The enumeration date for this NPI number is 2/8/2022 and was last updated on 2/8/2022.

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	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness	017058	NEW MEXICO	No
2	3104A0630X	Assisted Living Facility	Assisted Living, Behavioral Disturbances	017058	NORTH CAROLINA	No
3	310500000X	Intermediate Care Facility, Mental Illness		017058	NORTH CAROLINA	No
4	310400000X	Assisted Living Facility		017058	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	017058	OTHER	NORTH CAROLINA	FACILITY LICENSE NUMBER

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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