Provider Demographics
NPI:1750415006
Name:PERSONAL TOUCH ASSISTED LIVING
Entity type:Organization
Organization Name:PERSONAL TOUCH ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEVORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-321-2657
Mailing Address - Street 1:445 MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-9648
Mailing Address - Country:US
Mailing Address - Phone:828-321-2657
Mailing Address - Fax:828-321-2618
Practice Address - Street 1:445 MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-9648
Practice Address - Country:US
Practice Address - Phone:828-321-2657
Practice Address - Fax:828-321-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2119251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600809Medicaid
NC3409401Medicaid