Provider Demographics
NPI:1972866804
Name:ASSISTED GREATNESS
Entity Type:Organization
Organization Name:ASSISTED GREATNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MATRESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-918-1807
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:CLARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28433-0310
Mailing Address - Country:US
Mailing Address - Phone:910-647-2421
Mailing Address - Fax:910-647-0290
Practice Address - Street 1:53 SOUTH SMITH ST
Practice Address - Street 2:
Practice Address - City:CLARKTON
Practice Address - State:NC
Practice Address - Zip Code:28433
Practice Address - Country:US
Practice Address - Phone:910-918-1807
Practice Address - Fax:910-647-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05186310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility