Provider Demographics
NPI:1184836017
Name:HARRINGTON ASSISTED LIVING # 5
Entity Type:Organization
Organization Name:HARRINGTON ASSISTED LIVING # 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALFREIDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-522-0397
Mailing Address - Street 1:1685 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-9343
Mailing Address - Country:US
Mailing Address - Phone:910-522-0397
Mailing Address - Fax:910-522-0453
Practice Address - Street 1:1685 CANAL RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9343
Practice Address - Country:US
Practice Address - Phone:910-522-0397
Practice Address - Fax:910-522-0453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-078-0613104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness