Provider Demographics
NPI:1093255705
Name:L1932, LTD
Entity Type:Organization
Organization Name:L1932, LTD
Other - Org Name:GRISWOLD HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-515-1378
Mailing Address - Street 1:3329 WRIGHTSVILLE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4115
Mailing Address - Country:US
Mailing Address - Phone:910-515-1378
Mailing Address - Fax:910-338-4620
Practice Address - Street 1:3329 WRIGHTSVILLE AVE STE E
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4115
Practice Address - Country:US
Practice Address - Phone:910-515-1378
Practice Address - Fax:910-338-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3488253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care