Provider Demographics
NPI:1639355514
Name:BARNES FAMILY CARE HOME, INC
Entity Type:Organization
Organization Name:BARNES FAMILY CARE HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:BARNES
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-286-6854
Mailing Address - Street 1:PO BOX 2503
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28502-2503
Mailing Address - Country:US
Mailing Address - Phone:252-286-6854
Mailing Address - Fax:252-522-5941
Practice Address - Street 1:1106 E CASWELL ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-5308
Practice Address - Country:US
Practice Address - Phone:252-522-2634
Practice Address - Fax:252-522-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-054-061310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility