NPI 1922123892

Emma Lucille Garvin, ADMINISTRATOR

Practitioner Mental Illness Intermediate Care Facility Winston Salem, NC

Practice location

Address: 4527 Country Club Rd, Winston Salem, NC 27104-3517
Phone: (336) 765-8460
Fax: (336) 724-9674
Mailing address: 1161 Edenwood Dr, Winston Salem, NC 27103-6114

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence MHL 034-190 (NC)

Other Intermediate Care Facility, Mental Illness providers in North Carolina →

Registry record

NPI: 1922123892
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Mar 2007
Record last updated: 9 Jul 2007

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.