NPI 1215145966

Carillon Assisted Living of Southport

Organisation Lodging Provider Southport, NC

Practice location

Address: 1125 E Leonard St, Southport, NC 28461-8316
Phone: (910) 454-4001
Fax: (910) 454-0300
Mailing address: 4901 Waters Edge Dr STE. 200, Raleigh, NC 27606-2464

Authorised official

Name: Evie G. Maderios
Title: Accounts Receivable Manager
Phone: (919) 852-4000

Registered specialties

Lodging Provider Primary

Other Service Providers Taxonomy 177F00000X Licence HAL-068-023 (NC)

Other Lodging providers in North Carolina →

Registry record

NPI: 1215145966
Entity type: Organization
NPI issued: 18 May 2007
Record last updated: 19 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.