Basic Information
| Provider Information | |||||||||
| NPI: | 1063759397 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOMESTEAD HILL RETIREMENT LIMITED PARTNERSHIP | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HOMESTEAD HILLS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2105 HOMESTEAD HILLS DRIVE | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271036787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366590386 | ||||||||
| FaxNumber: | 3366598506 | ||||||||
| Practice Location | |||||||||
| Address1: | 2105 HOMESTEAD HILLS DRIVE | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271036787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366590386 | ||||||||
| FaxNumber: | 3366598506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2013 | ||||||||
| LastUpdateDate: | 03/26/2013 | ||||||||
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| AuthorizedOfficialLastName: | THOMPSON | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | O. | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7042461620 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | HAL-034-023 | NC | N | Nursing & Custodial Care Facilities | Assisted Living Facility | 314000000X | NH0633 | NC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.