| NPI | 1285753269 |
|---|---|
| Doing Business As | PORT SOUTH VILLAGE |
| Entity Type | Organization |
| Authorized Contact | BUDDY LOCKAMY Administrator 910-814-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL-065-008) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NC HAL- 065-606) |
| 310400000X Assisted Living Facility (Licence: NC HAL-065-005) | |
| 310400000X Assisted Living Facility (Licence: NC HAL-065-009) | |
| 310400000X Assisted Living Facility (Licence: NC HAL-065-010) | |
| 310400000X Assisted Living Facility (Licence: NC HAL-065-007) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |