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Tamela Blackwell
Adult Care Home Facility in Yanceyville, North Carolina
NPI 1689794323

Tamela Blackwell is an Adult Care Home Facility based in Roxboro, NC and is specialized in Adult Care Home. Tamela Blackwell practices in Yanceyville, NC. The NPI Number for Tamela Blackwell is 1689794323 and holds a License No. FCL017006 (North Carolina).

The current practice location address for Tamela Blackwell is 3592 Marshall Graves Rd, Yanceyville, NC and can be reached out via phone at 336-421-8880. You can also correspond with Tamela Blackwell through the mailing address at 203 N MAIN ST, ROXBORO, NC - 27573-5343 (mailing address contact number: 336-421-8880).

Location: 3592 Marshall Graves Rd, Yanceyville, NC, 27573-5343
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1689794323
Provider Name
Tamela Blackwell
Credential
Provider Entity Type
Organization
Address
3592 Marshall Graves Rd, Yanceyville, NC, 27573-5343
Phone Number
336-421-8880
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
7803662 05 NC
institution
Provider Business Practice Location Address Details
Address
3592 Marshall Graves Rd
City
Yanceyville
State
North Carolina
Zip
27379-8630
Phone Number
336-421-8880
Fax Number
person
Provider Business Mailing Address Details
Address
3592 Marshall Graves Rd
City
Yanceyville
State
North Carolina
Zip
27379-8630
Phone Number
336-421-8880
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.
FCL017006 (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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