Provider Demographics
NPI:1700943446
Name:SINGLETARY FAMILY CARE HOME #2
Entity Type:Organization
Organization Name:SINGLETARY FAMILY CARE HOME #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:SUITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:910-648-4235
Mailing Address - Street 1:20521 NC 410 HWY
Mailing Address - Street 2:
Mailing Address - City:BLADENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28320-8997
Mailing Address - Country:US
Mailing Address - Phone:910-648-4235
Mailing Address - Fax:910-648-2322
Practice Address - Street 1:20489 NC 410 HWY
Practice Address - Street 2:
Practice Address - City:BLADENBORO
Practice Address - State:NC
Practice Address - Zip Code:28320-8797
Practice Address - Country:US
Practice Address - Phone:910-648-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-009-010311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805426Medicaid