Healthcare Provider Details

I. General information

NPI: 1194825448
Provider Name (Legal Business Name): CENTURY CARE OF SHELBY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N MORGAN ST
SHELBY NC
28150-3848
US

IV. Provider business mailing address

1101 N MORGAN ST
SHELBY NC
28150-3848
US

V. Phone/Fax

Practice location:
  • Phone: 704-482-5396
  • Fax: 704-482-5823
Mailing address:
  • Phone: 704-482-5396
  • Fax: 704-482-5823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0405
License Number StateNC

VIII. Authorized Official

Name: MR. BRIAN S HILL
Title or Position: CFO / SECRETARY
Credential:
Phone: 919-290-2722