Ant Mary'S Family Care #2

Organization Active NPI Adult Care Home Facility · La Grange, NC

NPI 1386769040 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1386769040
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
FCL054046 (NC)
Legal business name
ANT MARY'S FAMILY CARE #2
Practice address
6198 Washington St
La Grange, NC 28551-6823
Phone
(252) 566-2933
NPI assigned
Mar 20, 2007
Organization subpart
No

Authorized official

Name
Mrs. Eula Britt
Title
Owner
Phone
(252) 566-2933

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Ant Mary'S Family Care (4 organizations share this tax ID)

Locations

6198 Washington St
La Grange, NC 28551
Phone (252) 566-2933

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X FCL054046 NC Yes

Addresses

Primary practice location

6198 Washington St
La Grange, NC 28551-6823

Mailing address

PO Box 516
La Grange, NC 28551-0516
Phone (252) 566-2933

Other identifiers

IdentifierTypeStateIssuer
7805045MedicaidNC

Other providers in La Grange, NC

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

Sources for this page

Verify at the official NPI Registry.