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General NPI Number Information
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NPI Number | 1962447565
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Entity Type | Organization
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Legal Business Name | REDWOOD LTC GROUP, LLC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 225 WHITE ST
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6351
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Country | US
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Telephone | 910-353-7222
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Fax | 910-353-8010
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Provider Business Mailing Address
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Address Line | 225 WHITE ST
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6351
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Country | US
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Telephone | 910-353-7222
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Fax | 910-353-8010
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAREN G MCDANIEL
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Credential |
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Telephone | 252-523-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0229
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License Number State | NC
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