Smith Street Village Family Care Home, LLC

Organization Active NPI Adult Care Home Facility · Leicester, NC

NPI 1275916942 · NPPES record last updated Jul 14, 2015

Key facts

NPI
1275916942
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
Legal business name
SMITH STREET VILLAGE FAMILY CARE HOME, LLC
Practice address
234 Country Time LN
Leicester, NC 28748-6213
Phone
(828) 676-5600
NPI assigned
Jun 30, 2015
Organization subpart
No

Authorized official

Name
Mr. Nicholas B Street, RN
Title
President/Administrator
Phone
(828) 676-5600

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Smith Street Village Family Care Home LLC (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Yes

Addresses

Primary practice location

234 Country Time LN
Leicester, NC 28748-6213

Mailing address

PO Box 889
Mountain Home, NC 28758-0889
Phone (828) 676-5600

Other providers in Leicester, NC

All providers in Leicester, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.