Provider Demographics
NPI:1700345162
Name:REDEEMED FAMILY CARE HOME OF BARNARDSVILLE
Entity type:Organization
Organization Name:REDEEMED FAMILY CARE HOME OF BARNARDSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURRETT
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:828-206-2324
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:NC
Mailing Address - Zip Code:28748-1406
Mailing Address - Country:US
Mailing Address - Phone:828-206-2324
Mailing Address - Fax:828-505-4919
Practice Address - Street 1:630 DILLINGHAM RD
Practice Address - Street 2:
Practice Address - City:BARNARDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28709-9717
Practice Address - Country:US
Practice Address - Phone:828-206-2324
Practice Address - Fax:828-505-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home