Autumn Village, Inc.

Organization Active NPI Adult Care Home Facility · Beulaville, NC

NPI 1992929475 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1992929475
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
HAL-031-014 (NC)
Legal business name
AUTUMN VILLAGE, INC.
Practice address
235 N NC 41 Hwy
Beulaville, NC 28518-8633
Phone
(910) 298-5877
Fax
(910) 298-5578
NPI assigned
Apr 13, 2007
Organization subpart
No

Authorized official

Name
Mrs. Rhonda Susan Ambrose
Title
Administrator
Phone
(910) 298-5877

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X HAL-031-014 NC Yes

Addresses

Primary practice location

235 N NC 41 Hwy
Beulaville, NC 28518-8633

Mailing address

PO Box 1140
Beulaville, NC 28518-1140
Phone (910) 298-5877

Other providers in Beulaville, NC

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

Sources for this page

Verify at the official NPI Registry.