Provider Demographics
NPI:1003138728
Name:BARNES FAMILY CARE #2
Entity Type:Organization
Organization Name:BARNES FAMILY CARE #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-286-6854
Mailing Address - Street 1:PO BOX 2503
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28502-2503
Mailing Address - Country:US
Mailing Address - Phone:252-286-6854
Mailing Address - Fax:252-522-5941
Practice Address - Street 1:405 NEW ST
Practice Address - Street 2:
Practice Address - City:SEVEN SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28578-9107
Practice Address - Country:US
Practice Address - Phone:252-286-6854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL 096039310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility