Healthcare Provider Details
I. General information
NPI: 1851937429
Provider Name (Legal Business Name): EC OPCO SALISBURY LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1915 MOORESVILLE RD
SALISBURY NC
28147-6200
US
IV. Provider business mailing address
ELMCROFT OF SALISBURY 5885 MEADOWS ROAD, #500
LAKE OSWEGO OR
97035
US
V. Phone/Fax
- Phone: 704-633-4666
- Fax: 704-612-9113
- Phone: 971-213-4234
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311Z00000X |
| Taxonomy | Custodial Care Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEAH
KUOR
Title or Position: LEGAL DIRECTOR OF MANAGEMENT CO
Credential:
Phone: 971-213-4234