Provider Demographics
| NPI: | 1730389065 |
|---|---|
| Name: | HALL'S FAMILY CARE HOME |
| Entity type: | Organization |
| Organization Name: | HALL'S FAMILY CARE HOME |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMINISTRATOR |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | SYLVIA |
| Authorized Official - Middle Name: | FLOOD |
| Authorized Official - Last Name: | HALL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 252-358-4445 |
| Mailing Address - Street 1: | 201 SOUTH MAIN ST. |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WINTON |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27986 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 252-358-4445 |
| Mailing Address - Fax: | 252-358-4445 |
| Practice Address - Street 1: | 201 S. MAIN ST. |
| Practice Address - Street 2: | |
| Practice Address - City: | WINTON |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27986-0405 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 252-358-4445 |
| Practice Address - Fax: | 252-358-4445 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-07-24 |
| Last Update Date: | 2007-07-24 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NC | FCL-046-006 | 311ZA0620X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |