Healthcare Provider Details

I. General information

NPI: 1609976901
Provider Name (Legal Business Name): CENTURY CARE OF CHERRYVILLE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7615 DALLAS CHERRYVILLE HWY
CHERRYVILLE NC
28021-9049
US

IV. Provider business mailing address

101 BAINES CT
CARY NC
27511-6625
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 919-290-2722
  • Fax: 919-447-7945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberNH0403
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0403
License Number StateNC

VIII. Authorized Official

Name: BRIAN SCOTT HILL
Title or Position: CFO / SECRETARY
Credential:
Phone: 919-290-2722