Healthcare Provider Details

I. General information

NPI: 1972641025
Provider Name (Legal Business Name): SPRINGVIEW SENIOR LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W WHITSETT ST
GRAHAM NC
27253-1635
US

IV. Provider business mailing address

PO BOX 2175
BURLINGTON NC
27216-2175
US

V. Phone/Fax

Practice location:
  • Phone: 336-222-8913
  • Fax: 336-222-1935
Mailing address:
  • Phone: 336-222-8913
  • Fax: 336-222-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL001029
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY DIX MCHUGH
Title or Position: OWNER ADMINISTRATOR
Credential:
Phone: 336-222-8913