Healthcare Provider Details

I. General information

NPI: 1750418802
Provider Name (Legal Business Name): ALAMANCE EXTENDED CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 BROOKWOOD AVE
BURLINGTON NC
27215-3200
US

IV. Provider business mailing address

1860 BROOKWOOD AVE
BURLINGTON NC
27215-3200
US

V. Phone/Fax

Practice location:
  • Phone: 336-570-8456
  • Fax: 336-570-8460
Mailing address:
  • Phone: 336-570-8456
  • Fax: 336-570-8460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0596
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES MICHAEL BENTON
Title or Position: CFO
Credential:
Phone: 336-570-8458