Provider Demographics
NPI:1225214000
Name:BARBARA DAVENPORT
Entity type:Organization
Organization Name:BARBARA DAVENPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-209-6986
Mailing Address - Street 1:1025 HWY. 45 S.
Mailing Address - Street 2:
Mailing Address - City:MERRY HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27957
Mailing Address - Country:US
Mailing Address - Phone:252-209-6986
Mailing Address - Fax:
Practice Address - Street 1:1025 HIGHWAY45 SOUTH
Practice Address - Street 2:
Practice Address - City:MERRY HILL
Practice Address - State:NC
Practice Address - Zip Code:27957
Practice Address - Country:US
Practice Address - Phone:252-209-6986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness