Glenn Krystle Manor

LBN: Glenn Krystle Manor
Glenn Krystle Manor is an health care organization with primary practice located at 220 Davis St , Fayetteville NC 28305-5346. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Glenn Krystle Manor can be contacted via phone (910) 486-8854, or through Garrison, Cynthia Danetta via phone (910) 527-4673.

Contact Information

Primary practice address
220 Davis St Fayetteville NC 28305-5346
Phone: (910) 486-8854
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Garrison, Cynthia Danetta
Phone: (910) 527-4673

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X FCL-026-049 North Carolina

Profile Details

NPI number 1700906070
LBN Legal business name Glenn Krystle Manor
DBA Doing business as
Authorized official Garrison, Cynthia Danetta
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700906070 NPPES
North Carolina MEDICAID 7805650

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