Provider Demographics
NPI:1497979462
Name:MORNING GLORY FAMILY CARE, INC
Entity Type:Organization
Organization Name:MORNING GLORY FAMILY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-242-4359
Mailing Address - Street 1:112 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:NC
Mailing Address - Zip Code:27830-9279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:919-242-3712
Practice Address - Street 1:112 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:NC
Practice Address - Zip Code:27830-9279
Practice Address - Country:US
Practice Address - Phone:919-242-4359
Practice Address - Fax:919-242-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-096-015311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7803006Medicaid