Provider Demographics
NPI:1750416558
Name:MISS DAISY'S & ASSOCIATES, INC
Entity type:Organization
Organization Name:MISS DAISY'S & ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINCEYS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:252-291-4915
Mailing Address - Street 1:PO BOX 1991
Mailing Address - Street 2:#C
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27894-1991
Mailing Address - Country:US
Mailing Address - Phone:252-291-4915
Mailing Address - Fax:252-291-6962
Practice Address - Street 1:500 WARD BLVD
Practice Address - Street 2:#C
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-1753
Practice Address - Country:US
Practice Address - Phone:252-291-4915
Practice Address - Fax:252-291-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409161Medicaid
NC7803850Medicaid
NC7804597Medicaid
NC7804785Medicaid
NC7803269Medicaid
NC7804645Medicaid