| Pettiford Homes Dba Mcdaniel Homes | |
|
315 Old Allensville Road Roxboro NC 27574 | |
| (336) 599-9863 | |
| Not Available |
| Full Name | Pettiford Homes Dba Mcdaniel Homes |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 315 Old Allensville Road, Roxboro, North Carolina |
| Authorized Official Name and Position | Lisa Pettiford (MANAGER) |
| Authorized Official Contact | 9193086672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pettiford Homes Dba Mcdaniel Homes Po Box 1659 Roxboro NC 27573-1659 Ph: (336) 599-9863 | Pettiford Homes Dba Mcdaniel Homes 315 Old Allensville Road Roxboro NC 27574 Ph: (336) 599-9863 |
| NPI Number | 1124441050 |
|---|---|
| Provider Enumeration Date | 01/29/2014 |
| Last Update Date | 03/02/2021 |
| Certification Date | 03/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124441050 | NPI | - | NPPES |
| 3418621 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 310400000X | Assisted Living Facility | MHL-073-066 (North Carolina) | Secondary |
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