Provider Demographics
NPI:1326278425
Name:GIVE CHRIST ADULT CARE HOME
Entity Type:Organization
Organization Name:GIVE CHRIST ADULT CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:CLAVON
Authorized Official - Last Name:GILCHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-436-0219
Mailing Address - Street 1:108 EASTWAY LN
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-3704
Mailing Address - Country:US
Mailing Address - Phone:336-436-0219
Mailing Address - Fax:336-270-3925
Practice Address - Street 1:108 EASTWAY LN
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-3704
Practice Address - Country:US
Practice Address - Phone:336-436-0219
Practice Address - Fax:336-270-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-001-129311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility