Healthcare Provider Details

I. General information

NPI: 1427778844
Provider Name (Legal Business Name): ELDERHAUS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 AMPHITHEATER DR
WILMINGTON NC
28401-6500
US

IV. Provider business mailing address

1950 AMPHITHEATER DR
WILMINGTON NC
28401-6500
US

V. Phone/Fax

Practice location:
  • Phone: 910-251-0660
  • Fax: 910-762-1732
Mailing address:
  • Phone: 910-251-0660
  • Fax: 910-762-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RUTH FINCH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 910-251-0660