| Doctor Name: | LARRY ALLEN MITCHELL |
| NPI Number: | 1497127484 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | FLC-011-330 |
| Business Practice Address: | 10 S Turkey Creek Rd Leicester, NC - 287486500 |
| Business Phone Number: | 8282314916 |
| Business Fax Number: | |
| Mailing Address: | Po Box 775, WEAVERVILLE |
| State: | NC |
| Postal Code: | 287870775 |
| Phone Number: | 8282314916 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2015 |
| NPI Last Update Date: | 10/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311ZA0620X |
| License Number: | FLC-011-330 |
| 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. |