Healthcare Provider Details

I. General information

NPI: 1669991865
Provider Name (Legal Business Name): ACCORDIUS HEALTH AT CLEMMONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 CLEMMONS RD
CLEMMONS NC
27012-8479
US

IV. Provider business mailing address

14C 53RD ST STE 220
BROOKLYN NY
11232-2644
US

V. Phone/Fax

Practice location:
  • Phone: 877-567-0402
  • Fax:
Mailing address:
  • Phone: 718-567-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0404
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BATYA GORELICK
Title or Position: COO
Credential:
Phone: 336-766-9158