Basic Information
| Provider Information | |||||||||
| NPI: | 1477177111 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | C&S ADULT CARE LLC, DBA DEAL CARE INN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1002 BELL RIDGE CT | ||||||||
| Address2: | |||||||||
| City: | ROCKWELL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281387437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042392199 | ||||||||
| FaxNumber: | 7048568196 | ||||||||
| Practice Location | |||||||||
| Address1: | 1075 DEAL RD | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281156719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048572817 | ||||||||
| FaxNumber: | 7048571628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2020 | ||||||||
| LastUpdateDate: | 05/28/2020 | ||||||||
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| AuthorizedOfficialLastName: | BLACK | ||||||||
| AuthorizedOfficialFirstName: | CASEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER MANAGER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7042392199 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 311ZA0620X | Y | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
No ID Information.