NPI 1609233295

Moderate Living for the Aging INC

Organisation Clinic/Center Mount Gilead, NC

Practice location

Address: 110 Roosevelt St, Mount Gilead, NC 27306-9606
Phone: (910) 439-1635
Mailing address: PO Box 1312, Mount Gilead, NC 27306-1312

Authorised official

Name: Mystery E Willis
Title: Ceo
Phone: (910) 439-1669

Registered specialties (3)

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence 90368 (NC)

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Assisted Living Facility

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 902768 (NC)

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Transportation Broker

Transportation Services Taxonomy 347E00000X

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Registry record

NPI: 1609233295
Entity type: Organization
NPI issued: 27 Jan 2016
Record last updated: 1 Dec 2021

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.