Provider Demographics
NPI:1013203108
Name:HESTER'S HEART FAMILY CARE HOME UNIT B
Entity Type:Organization
Organization Name:HESTER'S HEART FAMILY CARE HOME UNIT B
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-551-3295
Mailing Address - Street 1:12 ELLA LANE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701
Mailing Address - Country:US
Mailing Address - Phone:828-551-3295
Mailing Address - Fax:877-391-0026
Practice Address - Street 1:100 ELLA LN
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701-5503
Practice Address - Country:US
Practice Address - Phone:828-551-3295
Practice Address - Fax:877-391-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid