Organization Name: | NCAL- MOCKVILLE, INC. |
NPI Number: | 1114082419 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM BENTON (CEO) |
Mailing Address: | 150 Ken Dwiggins Dr Mocksville |
State: | NC US |
Postal Code: | 270282439 |
Phone Number: | 3367511209 |
Fax Number: | 3367510601 |
NPI Enumeration Date: | 12/27/2006 |
NPI Last Update Date: | 11/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | HAL-030-004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |