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General NPI Number Information
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NPI Number | 1366087744
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Entity Type | Organization
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Legal Business Name | CEDAR CREEK LIVING LLC
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Dates
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Enumeration Date | 11/09/2019
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Last Update Date | 11/09/2019
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Provider Practice Location Address
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Address Line | 2270 OAKLAND RD
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City | FOREST CITY
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State | NC
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Zip | 28043-6921
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Country | US
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Telephone | 828-229-3087
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Fax | 828-229-3099
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Provider Business Mailing Address
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Address Line | 2270 OAKLAND RD
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City | FOREST CITY
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State | NC
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Zip | 28043-6921
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Country | US
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Telephone | 828-229-3087
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Fax | 828-229-3099
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEPHEN WALKER
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Credential |
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Telephone | 828-429-1640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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