Provider Demographics
NPI:1669659231
Name:CARLENE B. WOODS DBA CREEKVIEW FAMILY CARE
Entity Type:Organization
Organization Name:CARLENE B. WOODS DBA CREEKVIEW FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-578-8374
Mailing Address - Street 1:3524 DICKEY MILL RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9006
Mailing Address - Country:US
Mailing Address - Phone:336-578-8374
Mailing Address - Fax:339-578-0633
Practice Address - Street 1:3524 DICKEY MILL RD
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9006
Practice Address - Country:US
Practice Address - Phone:336-578-8374
Practice Address - Fax:339-578-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL001034310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility