Statesville Assisted Living

Organization Preferred Provider Organization · NPI 1124191804

Statesville Assisted Living is a Preferred Provider Organization in Statesville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in: NC
In the registry since: 2006

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Practice location Address checks out

2147 Davie Ave
Statesville, NC 28625-9200
Phone: (704) 878-0123
Fax: (704) 878-8689

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary)	Taxonomy 305R00000X · Licence HAL-049-023 (NC)

Record details

NPI number	1124191804
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Aldo Baccala — Execuitve Officer · (707) 778-6719
NPI enumerated	November 17, 2006
Last updated in NPPES	August 22, 2020
Mailing address	2147 Davie Ave, Statesville, NC 28625-9200