Provider Demographics
NPI:1902348766
Name:PREFERRED HEALTH NORTH CAROLINA LLC
Entity Type:Organization
Organization Name:PREFERRED HEALTH NORTH CAROLINA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-464-4331
Mailing Address - Street 1:1786 NE COUNTY ROAD 150
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-3617
Mailing Address - Country:US
Mailing Address - Phone:229-561-5232
Mailing Address - Fax:
Practice Address - Street 1:205 MARTHA LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-9639
Practice Address - Country:US
Practice Address - Phone:850-464-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility