Provider Demographics
NPI:1144353475
Name:PERSONAL TOUCH FAMILY CARE HOME INC
Entity type:Organization
Organization Name:PERSONAL TOUCH FAMILY CARE HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-422-9998
Mailing Address - Street 1:9461 HIGHWAY 710 SOUTH
Mailing Address - Street 2:9461 HIGHWAY 710 SOUTH
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-8851
Mailing Address - Country:US
Mailing Address - Phone:910-422-9998
Mailing Address - Fax:
Practice Address - Street 1:9461 HWY 710 S.
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383
Practice Address - Country:US
Practice Address - Phone:910-422-9998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-078-019310400000X
NCFCL-078-045310400000X
NCFCL-078-047310400000X
NCFCL-078-018310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility