Provider Demographics
NPI:1124229059
Name:FISHER ADULT CARE INC
Entity Type:Organization
Organization Name:FISHER ADULT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-497-6367
Mailing Address - Street 1:PO BOX 782
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-0782
Mailing Address - Country:US
Mailing Address - Phone:910-582-3175
Mailing Address - Fax:
Practice Address - Street 1:403 CARR ST
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-2674
Practice Address - Country:US
Practice Address - Phone:910-582-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-077-008310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801798Medicare UPIN