Healthcare Provider Details

I. General information

NPI: 1871676015
Provider Name (Legal Business Name): SENIOR CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 PENSACOLA RD
BURNSVILLE NC
28714-3318
US

IV. Provider business mailing address

310 PENSACOLA RD PO BOX 248
BURNSVILLE NC
28714-3318
US

V. Phone/Fax

Practice location:
  • Phone: 828-682-9759
  • Fax: 828-682-9825
Mailing address:
  • Phone: 828-682-9759
  • Fax: 828-682-9825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0467
License Number StateNC

VIII. Authorized Official

Name: MR. CHRIS S KMET
Title or Position: ADMINISTRATOR
Credential:
Phone: 828-682-9759