Provider Demographics
NPI:1043812506
Name:PERKINS CARE HOME
Entity Type:Organization
Organization Name:PERKINS CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:PUETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-764-4864
Mailing Address - Street 1:2015 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-7420
Mailing Address - Country:US
Mailing Address - Phone:828-764-4864
Mailing Address - Fax:828-764-4866
Practice Address - Street 1:2015 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7420
Practice Address - Country:US
Practice Address - Phone:828-764-4864
Practice Address - Fax:828-764-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home