Provider Demographics
NPI:1275659369
Name:LEICESTER ELDERLY CARE SERVICES INC.
Entity Type:Organization
Organization Name:LEICESTER ELDERLY CARE SERVICES INC.
Other - Org Name:MEADOWBROOK FAMILY CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PONDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-683-4792
Mailing Address - Street 1:10 S TURKEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:NC
Mailing Address - Zip Code:28748-6500
Mailing Address - Country:US
Mailing Address - Phone:828-683-4792
Mailing Address - Fax:828-683-4792
Practice Address - Street 1:10 S TURKEY CREEK RD
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:NC
Practice Address - Zip Code:28748-6500
Practice Address - Country:US
Practice Address - Phone:828-683-4792
Practice Address - Fax:828-683-4792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-011-226311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home