| Organization Name: | TI-WILLOW HAVEN |
| NPI Number: | 1154409662 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH C TUTERA (OWNER) |
| Mailing Address: | 1703 Stonewall Rd Laurinburg |
| State: | NC US |
| Postal Code: | 283529706 |
| Phone Number: | 9102769211 |
| Fax Number: | 9102764535 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311ZA0620X |
| License Number: | HAL083012 |
| 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. |