Healthcare Provider Details

I. General information

NPI: 1295646438
Provider Name (Legal Business Name): RIDGELINE CARE NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 CENTERVIEW DR
RALEIGH NC
27606-3363
US

IV. Provider business mailing address

500 WESTOVER DR STE 37848
SANFORD NC
27330-8941
US

V. Phone/Fax

Practice location:
  • Phone: 984-375-5300
  • Fax:
Mailing address:
  • Phone: 984-375-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: CHAD NEISWONGER
Title or Position: OWNER
Credential:
Phone: 336-743-2423