Provider Demographics
NPI:1336559129
Name:GRAHAM'S SENIOR LIVING HOMES INC
Entity Type:Organization
Organization Name:GRAHAM'S SENIOR LIVING HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-838-9204
Mailing Address - Street 1:107 GRAHAM LN
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-9449
Mailing Address - Country:US
Mailing Address - Phone:252-838-9204
Mailing Address - Fax:252-838-9203
Practice Address - Street 1:107 GRAHAM LN
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-9449
Practice Address - Country:US
Practice Address - Phone:252-838-9204
Practice Address - Fax:252-838-9203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAHAM'S SENIOR LIVING HOMES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-016-020310400000X
NCFCL-016-019310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility