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NPI Code Detail

MEDICARE: THE LAURELS OF GREENTREE RIDGE, INC

MEDICARE: THE LAURELS OF GREENTREE RIDGE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care FacilityNH0463NC
2314000000XSkilled Nursing FacilityNH0463NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30097YOTHERNCBLUE CROSS BLUE SHIELD #
4NH0463OTHERNCNURSING HOME LICENSE #

General Provider Information

NPI Number : 1598710949
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE LAURELS OF GREENTREE RIDGE, INC
Provider Business Mailing Address
First Line : 8181 WORTHINGTON RD
Second Line :
City : WESTERVILLE
State : OH
Zip : 43082-8067
Country : US
Telephone Number : 614-794-8800
Fax Number : 614-794-8826
Provider Business Practice Location Address
First Line : 70 SWEETEN CREEK RD
Second Line :
City : ASHEVILLE
State : NC
Zip : 28803-2318
Country : US
Telephone Number : 828-274-7646
Fax Number : 828-277-4752
Authorized Official
Title or Position : CFO
Name : ANIS KHAN
Credential :
Telephone Number : 614-794-8800
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/03/2017

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Directions to “THE LAURELS OF GREENTREE RIDGE, INC ” Practice Location

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