Healthcare Provider Details

I. General information

NPI: 1013482314
Provider Name (Legal Business Name): LARCHWOOD CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 ROCKY RIVER DR
CLEVELAND OH
44135-1175
US

IV. Provider business mailing address

PO BOX 1667
HICKORY NC
28603-1667
US

V. Phone/Fax

Practice location:
  • Phone: 216-941-6100
  • Fax: 216-377-7322
Mailing address:
  • Phone: 828-324-8898
  • Fax: 828-322-9598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LOWELL PRENTICE THOMPSON II
Title or Position: MANAGING MEMBER
Credential:
Phone: 216-952-9358