Provider Demographics
NPI:1205593910
Name:TRULY GRATEFUL FAMILY CARE HOME
Entity type:Organization
Organization Name:TRULY GRATEFUL FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GARNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-263-6860
Mailing Address - Street 1:PO BOX 2554
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-2554
Mailing Address - Country:US
Mailing Address - Phone:336-263-6860
Mailing Address - Fax:
Practice Address - Street 1:1313 ELRADO ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-8966
Practice Address - Country:US
Practice Address - Phone:336-263-6860
Practice Address - Fax:336-652-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home