| NPI | 1396411161 |
|---|---|
| Doing Business As | SOUTHFORK |
| Entity Type | Organization |
| Authorized Contact | CHARLES E TREFZGER Manager 828-322-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-08-20 |