Provider Demographics
NPI:1073948295
Name:JOANNS FAMILY CARE HOME
Entity Type:Organization
Organization Name:JOANNS FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-683-0898
Mailing Address - Street 1:245 ANCHOR DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701-9700
Mailing Address - Country:US
Mailing Address - Phone:828-683-0898
Mailing Address - Fax:828-683-0604
Practice Address - Street 1:245 ANCHOR DR
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701-9700
Practice Address - Country:US
Practice Address - Phone:828-683-0898
Practice Address - Fax:828-683-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL011199311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5258891OtherLICENSE