IndividualActive
Archie Crocker
NPI 1720117526 · Assisted Living Facility · Kings Mountain, NC
Provider details
- NPI number
- 1720117526
- Entity type
- Individual
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- FCL 023-010 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
429 Crocker Rd
Kings Mountain, NC 28086-4004
Phone: (704) 739-6429
Approximate (ZIP-level) locationGet directions
Mailing address
102 Country Creek Dr
Kings Mountain, NC 28086-8903
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.