| NPI | 1669503645 |
|---|---|
| Doing Business As | MELVIN L. BLACKWELL |
| Entity Type | Organization |
| Authorized Contact | EDITH BLACKWELL Administrator 336-342-2960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-079-019) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: NC FCL-079-019) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-07-09 |