DIXIE REST HOME 1; NPI #1417028135

Contact Information

DIXIE REST HOME 1

310 NORTH MARTIN LUTHER KING AVENUE
ENFIELD, NC 27823

Phone: 252-445-5665
Fax: 252-445-3466
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Assisted Living Facility	310400000X

Indicates primary specialty

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NPI Profile & details for DIXIE REST HOME 1

NPI # 1417028135

LBN Legal business name DIXIE REST HOME 1

Authorized official RONALD WOOD - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/13/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

NC	License #	HAL042002
NC	Medicaid	7801459

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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