Provider Demographics
NPI:1568124303
Name:CHESTERFIELD FAMILY CARE HOME, LLC.
Entity Type:Organization
Organization Name:CHESTERFIELD FAMILY CARE HOME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-403-7129
Mailing Address - Street 1:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD COLLEGE
Mailing Address - State:NC
Mailing Address - Zip Code:28671-0967
Mailing Address - Country:US
Mailing Address - Phone:828-403-7129
Mailing Address - Fax:828-438-1000
Practice Address - Street 1:2630 PAX HILL RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7754
Practice Address - Country:US
Practice Address - Phone:828-437-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home