| Ann's Country Manor | |
|
5312 Six Forks Rd Ste 301 Raleigh NC 27609-4458 | |
| (919) 790-7663 | |
| (919) 790-6990 |
| Full Name | Ann's Country Manor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5312 Six Forks Rd Ste 301, Raleigh, North Carolina |
| Authorized Official Name and Position | Sandra Mayo (COO) |
| Authorized Official Contact | 9197907663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ann's Country Manor 105 Avery St Garner NC 27529-3133 Ph: () - | Ann's Country Manor 5312 Six Forks Rd Ste 301 Raleigh NC 27609-4458 Ph: (919) 790-7663 |
| NPI Number | 1558776948 |
|---|---|
| Provider Enumeration Date | 06/25/2014 |
| Last Update Date | 03/08/2021 |
| Certification Date | 03/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558776948 | NPI | - | NPPES |
| 7804626 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-092-861 (North Carolina) | Primary |
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