Provider Demographics
NPI:1215052683
Name:FLESHERS FAIRVIEW REST HOME INC
Entity type:Organization
Organization Name:FLESHERS FAIRVIEW REST HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-628-1018
Mailing Address - Street 1:3016 CANE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-8743
Mailing Address - Country:US
Mailing Address - Phone:828-628-1018
Mailing Address - Fax:828-628-0209
Practice Address - Street 1:3016 CANE CREEK RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-8743
Practice Address - Country:US
Practice Address - Phone:828-628-1018
Practice Address - Fax:828-628-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0517313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801150Medicaid