Provider Demographics
NPI:1003949223
Name:YELTON & ASSOCIATES
Entity Type:Organization
Organization Name:YELTON & ASSOCIATES
Other - Org Name:COLONIAL MANOR REST HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:YELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-287-7353
Mailing Address - Street 1:160 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-8058
Mailing Address - Country:US
Mailing Address - Phone:828-287-7353
Mailing Address - Fax:
Practice Address - Street 1:160 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-8058
Practice Address - Country:US
Practice Address - Phone:828-287-7353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801174Medicaid