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Mildred Blackwell
Adult Care Home Facility in Elon, North Carolina
NPI 1164542882

Mildred Blackwell is an Adult Care Home Facility based in Roxboro, NC and is specialized in Adult Care Home. Mildred Blackwell practices in Elon, NC. The NPI Number for Mildred Blackwell is 1164542882 and holds a License No. HAL017003 (North Carolina).

The current practice location address for Mildred Blackwell is 3658 Cherry Grove Rd, Elon, NC and can be reached out via phone at 336-421-0646.

Location: 3658 Cherry Grove Rd, Elon, NC, 27573-5343
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164542882
Provider Name
Mildred Blackwell
Credential
Provider Entity Type
Organization
Address
3658 Cherry Grove Rd, Elon, NC, 27573-5343
Phone Number
336-421-0646
Fax Number
Provider Enumeration Date
03/29/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7801723 05 NC
institution
Provider Business Practice Location Address Details
Address
3658 Cherry Grove Rd
City
Elon
State
North Carolina
Zip
27244-9483
Phone Number
336-421-0646
Fax Number
person
Provider Business Mailing Address Details
Address
3658 Cherry Grove Rd
City
Elon
State
North Carolina
Zip
27244-9483
Phone Number
336-421-0646
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
HAL017003 (North Carolina)
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
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