Healthcare Provider Details

I. General information

NPI: 1174307532
Provider Name (Legal Business Name): ESLIKER-SAMUELS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 SARATOGA DR
RALEIGH NC
27604-3446
US

IV. Provider business mailing address

5812 SNOOKS TRL
WAKE FOREST NC
27587-8423
US

V. Phone/Fax

Practice location:
  • Phone: 919-264-0775
  • Fax: 844-384-9849
Mailing address:
  • Phone: 919-264-0775
  • Fax: 844-384-9849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELLEN ESLIKER-SAMUELS
Title or Position: PRESIDENT
Credential:
Phone: 919-264-0775