Provider Demographics
NPI:1114369923
Name:LILY'S BLESSINGS FAMILY CARE HOME
Entity Type:Organization
Organization Name:LILY'S BLESSINGS FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:BROTHERS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-331-1720
Mailing Address - Street 1:1246 WEEKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8408
Mailing Address - Country:US
Mailing Address - Phone:252-331-1720
Mailing Address - Fax:252-330-8030
Practice Address - Street 1:1246 WEEKSVILLE RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8408
Practice Address - Country:US
Practice Address - Phone:252-331-1720
Practice Address - Fax:252-330-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-070-010310400000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility