Organization Name:  GLENFLORA


Practice Location:
5701 N FAYETTEVILLE RD  LUMBERTON, NC 28360 US
Tel: 910-739-2821  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	311ZA0620X	Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home	NC	NH0533
N	332BP3500X	Suppliers Durable Medical Equipment & Medical Supplies	NC
Y	314000000X	Nursing & Custodial Care Facilities Skilled Nursing Facility	NC	NH0533

Other Provider Identifiers:

Issuer	Number	State	Type
	3496069	NC	05
	7804192	NC	05
	3405194	NC	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin