Provider Demographics
NPI:1245684711
Name:MCCLUNEY'S FAMILY CARE HOME
Entity type:Organization
Organization Name:MCCLUNEY'S FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:LATRESIA
Authorized Official - Last Name:PEAK MCCLUNEY
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:704-406-9721
Mailing Address - Street 1:PO BOX 2117
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28151-2117
Mailing Address - Country:US
Mailing Address - Phone:704-406-9721
Mailing Address - Fax:
Practice Address - Street 1:837 W WARREN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5064
Practice Address - Country:US
Practice Address - Phone:704-406-9721
Practice Address - Fax:704-406-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home