person
Mrs. Emma Lucille Garvin, ADMINISTRATOR
Mental Illness Intermediate Care Facility in Winston Salem, North Carolina
NPI 1922123892

Emma Lucille Garvin is a Mental Illness Intermediate Care Facility based in Winston Salem, NC. Emma Lucille Garvin practices in Winston Salem, NC and has the professional credentials of ADMINISTRATOR. The NPI Number for Emma Lucille Garvin is 1922123892 and holds a License No. MHL 034-190 (North Carolina).

The current practice location address for Emma Lucille Garvin is 4527 Country Club Rd, Winston Salem, NC and can be reached out via phone at 336-765-8460 and via fax at 336-724-9674.

Location: 4527 Country Club Rd, Winston Salem, NC, 27103-6114
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Provider Profile Details
NPI Number
1922123892
Provider Name
Emma Lucille Garvin
Credential
ADMINISTRATOR
Provider Entity Type
Individual
Gender
Female
Address
4527 Country Club Rd, Winston Salem, NC, 27103-6114
Phone Number
336-765-8460
Fax Number
336-724-9674
Provider Enumeration Date
03/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7805234 05 NC
institution
Provider Business Practice Location Address Details
Address
4527 Country Club Rd
City
State
Zip
27104-3517
Phone Number
336-765-8460
Fax Number
336-724-9674
person
Provider Business Mailing Address Details
Address
4527 Country Club Rd
City
State
Zip
27104-3517
Phone Number
336-765-8460
Fax Number
336-724-9674
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mental Illness
Speciality
-
Taxonomy
License No.
MHL 034-190 (North Carolina)
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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