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General NPI Number Information
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NPI Number | 1871305789
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Entity Type | Organization
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Legal Business Name | SPRING ARBOR CREEKS CROSSING NC TENANT, LLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 8398 FAYETTEVILLE RD
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City | RAEFORD
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State | NC
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Zip | 28376-6500
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Country | US
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Telephone | 910-985-5721
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Fax |
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Provider Business Mailing Address
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Address Line | 420 S ORANGE AVE STE 400
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City | ORLANDO
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State | FL
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Zip | 32801-4908
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Country | US
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Telephone | 407-810-2065
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN R MADDRON
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Credential |
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Telephone | 407-810-4621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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