Provider Demographics
NPI:1154741908
Name:BUNCH LOVE FAMILY CARE HOME
Entity type:Organization
Organization Name:BUNCH LOVE FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-245-1805
Mailing Address - Street 1:2100 COTTON CIR SE
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-6560
Mailing Address - Country:US
Mailing Address - Phone:252-245-1805
Mailing Address - Fax:
Practice Address - Street 1:2100 COTTON CIR SE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-6560
Practice Address - Country:US
Practice Address - Phone:252-245-1805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-20
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility