Provider Demographics
NPI:1992499305
Name:ROCKY MOUNT ASSISTED LIVING AND MEMORY CARE, LLC
Entity type:Organization
Organization Name:ROCKY MOUNT ASSISTED LIVING AND MEMORY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-308-3533
Mailing Address - Street 1:891 NOELL LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1742
Mailing Address - Country:US
Mailing Address - Phone:252-210-3751
Mailing Address - Fax:252-231-1461
Practice Address - Street 1:891 NOELL LN
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1742
Practice Address - Country:US
Practice Address - Phone:252-210-3751
Practice Address - Fax:252-231-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home