Provider Demographics
NPI:1982063327
Name:SUBTLE LIVING, LLC
Entity Type:Organization
Organization Name:SUBTLE LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:910-644-4820
Mailing Address - Street 1:7508 WILKINS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9338
Mailing Address - Country:US
Mailing Address - Phone:910-644-4820
Mailing Address - Fax:
Practice Address - Street 1:183 BONNEY LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-3735
Practice Address - Country:US
Practice Address - Phone:910-644-4820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home