| Organization Name: | RUDD RIDGE FAMILY CARE HOME INC. |
| NPI Number: | 1063526002 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TONYA B. RIBELIN (CO-OWNER / ADMINISTRATOR) |
| Mailing Address: | 643 Rudd Ridge Rd Yanceyville |
| State: | NC US |
| Postal Code: | 273798460 |
| Phone Number: | 3364217341 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | FCL-017-039 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |