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NPI Code Detail

MEDICARE: ARC WILORA ASSISTED LIVING LLC

MEDICARE: ARC WILORA ASSISTED LIVING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityHAL060060NC

General Provider Information

NPI Number : 1629280961
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARC WILORA ASSISTED LIVING LLC
Provider Business Mailing Address
First Line : 6053 WILORA LAKE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-2833
Country : US
Telephone Number : 704-537-8848
Fax Number : 704-537-0118
Provider Business Practice Location Address
First Line : 6053 WILORA LAKE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-2833
Country : US
Telephone Number : 704-537-8848
Fax Number : 704-537-0118
Authorized Official
Title or Position : EXECUTIVE VP & CHIEF ACCOUNTING OFF
Name : BRYAN RICHARDSON
Credential :
Telephone Number : 615-564-8190
Provider Enumeration Date : 05/07/2007
Last Update Date : 08/22/2020

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Directions to “ARC WILORA ASSISTED LIVING LLC ” Practice Location

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