MRS. EMMA LUCILLE GARVIN ADMINISTRATOR NPI 1922123892

NPI Information

NPI: 1922123892
Provider Name: MRS. EMMA LUCILLE GARVIN, ADMINISTRATOR
Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Individual
Address:
4527 COUNTRY CLUB RD
WINSTON SALEM, NC
ZIP 27104
Phone: (336) 765-8460
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MRS. Emma Lucille Garvin, ADMINISTRATOR is an intermediate care facility mental illness in Winston Salem, NC. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. MRS. Emma Lucille Garvin, ADMINISTRATOR NPI is 1922123892. 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:

4527 COUNTRY CLUB RD
WINSTON SALEM, NC
ZIP 27104-517
Phone: (336) 765-8460
Fax: (336) 724-9674

The enumeration date for this NPI number is 3/20/2007 and was last updated on 7/9/2007.

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	310500000X	Intermediate Care Facility, Mental Illness		MHL 034-190	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	7805234	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: 11/14/2023

NPI Synchronization or Removal

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