Provider Demographics
NPI:1881819100
Name:GP YANCEY ENTERPRISES
Entity Type:Organization
Organization Name:GP YANCEY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOROWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-599-7502
Mailing Address - Street 1:183 DEE YANCEY RD
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27574-6435
Mailing Address - Country:US
Mailing Address - Phone:336-599-7502
Mailing Address - Fax:336-599-6872
Practice Address - Street 1:5975 BOSTON RD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27574-9182
Practice Address - Country:US
Practice Address - Phone:336-599-7502
Practice Address - Fax:336-599-6872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL073-012311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home