Provider Demographics
NPI:1548595770
Name:HESTERS HEART OF BLACK MOUNTAIN
Entity Type:Organization
Organization Name:HESTERS HEART OF BLACK MOUNTAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-551-3295
Mailing Address - Street 1:136 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-3509
Mailing Address - Country:US
Mailing Address - Phone:828-669-6783
Mailing Address - Fax:828-669-6783
Practice Address - Street 1:136 CENTER AVE
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-3509
Practice Address - Country:US
Practice Address - Phone:828-669-6783
Practice Address - Fax:828-669-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility