Provider Demographics
NPI:1982983664
Name:REECE, MILDRED RUTH
Entity type:Individual
Prefix:
First Name:MILDRED
Middle Name:RUTH
Last Name:REECE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 DANIEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-5557
Mailing Address - Country:US
Mailing Address - Phone:828-665-6578
Mailing Address - Fax:828-665-4732
Practice Address - Street 1:110 DANIEL RIDGE RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-5557
Practice Address - Country:US
Practice Address - Phone:828-665-6578
Practice Address - Fax:828-665-4732
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-011-289311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home