Southern Ave Rest Home
NPI #1083898589 in Fayetteville, North Carolina
Provider Information
- NPI Number
- 1083898589
- Entity Type
- Organization
- Organization Name
- Southern Ave Rest Home
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Dec 20, 2007
- Last Updated
- Dec 20, 2007
Practice Location
- Address
- 1124 SOUTHERN AVE
- City
- Fayetteville
- State
- North Carolina
- ZIP Code
- 28306-1754
- Phone
- (910) 286-8118
Authorized Official
- Name
- MR. NEILL JONES
- Title
- OWNER
- Phone
- (910) 484-4291
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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