Statesville Assisted Living
NPI #1124191804 in Statesville, North Carolina
Provider Information
- NPI Number
- 1124191804
- Entity Type
- Organization
- Organization Name
- Statesville Assisted Living
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Nov 17, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2147 DAVIE AVE
- City
- Statesville
- State
- North Carolina
- ZIP Code
- 28625-9200
- Phone
- (704) 878-0123
Authorized Official
- Name
- MR. ALDO BACCALA
- Title
- EXECUITVE OFFICER
- Phone
- (707) 778-6719
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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