Healthcare Provider Details

I. General information

NPI: 1407227382
Provider Name (Legal Business Name): THE CARDINAL AT NORTH HILLS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 GARDEN AT NORTH HILLS
RALEIGH NC
27609
US

IV. Provider business mailing address

5790 FLEET ST SUITE 300
CARLSBAD CA
92008-4703
US

V. Phone/Fax

Practice location:
  • Phone: 760-804-5900
  • Fax:
Mailing address:
  • Phone: 760-804-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TERRI NOVAK
Title or Position: VICE PRESIDENT
Credential:
Phone: 760-804-5900