Provider Demographics
NPI:1376769547
Name:B&V FAMILY HOMES SERVICES,LLC
Entity Type:Organization
Organization Name:B&V FAMILY HOMES SERVICES,LLC
Other - Org Name:MATTIE'S FAMILY CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER/COOWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-463-1553
Mailing Address - Street 1:45053 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NC
Mailing Address - Zip Code:28127-8619
Mailing Address - Country:US
Mailing Address - Phone:704-463-4477
Mailing Address - Fax:704-463-4477
Practice Address - Street 1:45053 BALDWIN RD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NC
Practice Address - Zip Code:28127-8619
Practice Address - Country:US
Practice Address - Phone:704-463-1553
Practice Address - Fax:704-463-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL084008310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility