Carillon Assisted Living of Southport

NPI #1215145966 in Southport, North Carolina

Provider Information

NPI Number: 1215145966
Entity Type: Organization
Organization Name: Carillon Assisted Living of Southport
Primary Specialty: Lodging
Enumeration Date: May 18, 2007
Last Updated: Jun 19, 2008

Practice Location

Address: 1125 E LEONARD ST
City: Southport
State: North Carolina
ZIP Code: 28461-8316
Phone: (910) 454-4001

Authorized Official

Name: MRS. EVIE G. MADERIOS
Title: ACCOUNTS RECEIVABLE MANAGER
Phone: (919) 852-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Lodging	177F00000X	Primary

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