Provider Demographics
NPI:1316062953
Name:MINTZ CARE HOMES INC.
Entity type:Organization
Organization Name:MINTZ CARE HOMES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDWINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-649-3420
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0041
Mailing Address - Country:US
Mailing Address - Phone:828-649-3420
Mailing Address - Fax:828-683-1409
Practice Address - Street 1:302 MILLER RD.
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-0041
Practice Address - Country:US
Practice Address - Phone:828-649-3420
Practice Address - Fax:828-683-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-057-001311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7802080Medicaid