Basic Information
| Provider Information | |||||||||
| NPI: | 1477791952 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ZION HILL LIVING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 561 ZION HILL RD | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287384310 | ||||||||
| FaxNumber: | 8287380350 | ||||||||
| Practice Location | |||||||||
| Address1: | 561 ZION HILL RD | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287384310 | ||||||||
| FaxNumber: | 8287380350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2009 | ||||||||
| LastUpdateDate: | 01/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | WILSON | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MAMAGER | ||||||||
| AuthorizedOfficialTelephone: | 8287383046 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 311ZA0620X | FCL059011 | NC | Y | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
ID Information
| ID | Type | State | Issuer | Description | FCL059011 | 01 | NC | LICENSE | OTHER |