Provider Demographics
NPI:1952650327
Name:ASHLEE PLACE
Entity Type:Organization
Organization Name:ASHLEE PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:GWYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-327-6284
Mailing Address - Street 1:PO BOX 2361
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27323-2361
Mailing Address - Country:US
Mailing Address - Phone:336-349-3610
Mailing Address - Fax:336-342-4473
Practice Address - Street 1:538 WARRINER STREET
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320
Practice Address - Country:US
Practice Address - Phone:336-327-6284
Practice Address - Fax:336-342-4473
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRACESON MANOR ADULT CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility