Healthcare Provider Details

I. General information

NPI: 1033568258
Provider Name (Legal Business Name): RGM AL HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 INDEPENDENCE AVE
NORTH WILKESBORO NC
28659
US

IV. Provider business mailing address

328 1ST AVE NW
HICKORY NC
28601-6123
US

V. Phone/Fax

Practice location:
  • Phone: 828-244-5266
  • Fax:
Mailing address:
  • Phone: 828-322-5535
  • Fax: 828-326-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL097015
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: CHARLES E TREFZGER
Title or Position: MANAGER
Credential:
Phone: 828-322-5535