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Mr. Estella Joann Spann
Assisted Living Facility in Blanch, North Carolina
NPI 1639823784

Estella Joann Spann is an Assisted Living Facility based in Blanch, NC. Estella Joann Spann practices in Blanch, NC. The NPI Number for Estella Joann Spann is 1639823784 and holds a License No. 017058 (North Carolina).

The current practice location address for Estella Joann Spann is 1136 Bertha Wilson Rd, Blanch, NC and can be reached out via phone at 336-694-1878 and via fax at 336-694-1878.

Location: 1136 Bertha Wilson Rd, Blanch, NC, 27212-9795
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639823784
Provider Name
Estella Joann Spann
Credential
Provider Entity Type
Individual
Gender
Female
Address
1136 Bertha Wilson Rd, Blanch, NC, 27212-9795
Phone Number
336-694-1878
Fax Number
336-694-1878
Provider Enumeration Date
02/08/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
017058 01 NC FACILITY LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
1136 Bertha Wilson Rd
City
Blanch
State
North Carolina
Zip
27212-9795
Phone Number
336-694-1878
Fax Number
336-694-1878
person
Provider Business Mailing Address Details
Address
1136 Bertha Wilson Rd
City
Blanch
State
North Carolina
Zip
27212-9795
Phone Number
336-694-1878
Fax Number
336-694-1878
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
017058 (North Carolina)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
person
Provider's Taxonomy Details 2
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Mental Illness
Taxonomy
3104A0625X
License No.
017058 (North Carolina)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
person
Provider's Taxonomy Details 3
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Behavioral Disturbances
Taxonomy
3104A0630X
License No.
017058 (North Carolina)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
person
Provider's Taxonomy Details 4
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mental Illness
Speciality
-
Taxonomy
310500000X
License No.
017058 (New Mexico)
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
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