Healthcare Provider Details

I. General information

NPI: 1225019359
Provider Name (Legal Business Name): THE CEDARS OF CHAPEL HILL CLUB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GREEN CEDAR LN
CHAPEL HILL NC
27517
US

IV. Provider business mailing address

100 CEDAR CLUB CIR
CHAPEL HILL NC
27517-7809
US

V. Phone/Fax

Practice location:
  • Phone: 919-259-7903
  • Fax: 919-259-7943
Mailing address:
  • Phone: 919-259-7000
  • Fax: 919-259-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0615
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROBERT E WOODRUFF
Title or Position: PRESIDENT
Credential:
Phone: 919-259-7000