Healthcare Provider Details
I. General information
NPI: 1174374300
Provider Name (Legal Business Name): FLETCHER OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 06/26/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
86 OLD AIRPORT ROAD
FLETCHER NC
28732-9232
US
IV. Provider business mailing address
211 BLVD OF THE AMERICAS SUITE 500
LAKEWOOD NJ
08701-4775
US
V. Phone/Fax
- Phone: 828-654-9060
- Fax:
- Phone: 908-506-4204
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TEVI
ALTER
Title or Position: CEO
Credential:
Phone: 908-506-4204