1821280215 NPI number — AMERICA'S LIVING CENTERS LLC

Table of content: (NPI 1821280215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821280215 NPI number — AMERICA'S LIVING CENTERS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICA'S LIVING CENTERS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAROLINA LIVING CENTER #1
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821280215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
495 ZION HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28752-6304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-738-3046
Provider Business Mailing Address Fax Number:
828-738-0350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1308 HEBRON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-692-9560
Provider Business Practice Location Address Fax Number:
828-738-0350
Provider Enumeration Date:
08/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HODGES
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER/OPERATOR
Authorized Official Telephone Number:
828-738-3046

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X , with the licence number:  FCL-045-026 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FCL-045-026 . This is a "LICENSE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".