NPI 1285285601

Gahc3 Clemmons Nc Trs Sub, LLC

Organisation Custodial Care Facility Clemmons, NC

Practice location

Address: 1165 S Peace Haven Rd, Clemmons, NC 27012-8910
Phone: (336) 766-6220
Fax: (336) 766-7613
Mailing address: 18191 von Karman Ave STE 300, Irvine, CA 92612-7106

Authorised official

Name: Danny Prosky
Title: President
Phone: (949) 270-9200

Registered specialties (2)

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X

Other Custodial Care Facility providers in North Carolina →

Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

Registry record

NPI: 1285285601
Entity type: Organization
NPI issued: 26 Sep 2019
Record last updated: 28 Oct 2019

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.