Mt. Pisgah Family Care

Organization Active NPI Adult Care Home Facility · Candler, NC

NPI 1346360625 · NPPES record last updated Feb 16, 2011

Key facts

NPI
1346360625
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
FCL-011-048 (NC)
Legal business name
MT. PISGAH FAMILY CARE
Practice address
33 Upper Saw Branch Rd
Candler, NC 28715-8196
Phone
(828) 779-5588
NPI assigned
Mar 30, 2007
Organization subpart
No

Authorized official

Name
Young S Lee
Title
Owner
Phone
(828) 779-5588

Corporate family (same tax ID) 18

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

National Provider Directory

Tax ID family
Evergreen Living 4 (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X FCL-011-048 NC Yes

Addresses

Primary practice location

33 Upper Saw Branch Rd
Candler, NC 28715-8196

Mailing address

PO Box 2077
Leicester, NC 28748-2077
Phone (828) 779-5588

Other identifiers

IdentifierTypeStateIssuer
7801202MedicaidNC

Other providers in Candler, NC

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

Sources for this page

Verify at the official NPI Registry.