Healthcare Provider Details

I. General information

NPI: 1730362476
Provider Name (Legal Business Name): SENTERS HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 RAWLS CLUB RD
FUQUAY VARINA NC
27526-8031
US

IV. Provider business mailing address

495 ZION HILL RD
MARION NC
28752-6304
US

V. Phone/Fax

Practice location:
  • Phone: 919-552-6264
  • Fax: 919-567-0793
Mailing address:
  • Phone: 828-738-3053
  • Fax: 828-738-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberHAL043021
License Number StateNC

VIII. Authorized Official

Name: KENNETH R HODGES
Title or Position: MANAGER
Credential:
Phone: 828-738-3053