Provider Demographics
NPI:1801065602
Name:TWENTY PACK MANAGEMENT CORP.
Entity type:Organization
Organization Name:TWENTY PACK MANAGEMENT CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-787-0777
Mailing Address - Street 1:4801 EDWARDS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4417
Mailing Address - Country:US
Mailing Address - Phone:919-787-0777
Mailing Address - Fax:919-787-6105
Practice Address - Street 1:4801 EDWARDS MILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4417
Practice Address - Country:US
Practice Address - Phone:919-787-0777
Practice Address - Fax:919-787-6105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility