Birch LTC Group, LLC
Organization Active NPI Adult Care Home Facility · La Grange, NC
NPI 1265468441 · NPPES record last updated Apr 7, 2017
Key facts
- NPI
- 1265468441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- License
- HAL096001 (NC)
- Legal business name
- BIRCH LTC GROUP, LLC
- Practice address
- 167 Fussell Rd
La Grange, NC 28551-7745 - Phone
- (252) 566-4112
- Fax
- (252) 566-2267
- NPI assigned
- Jun 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Karen G McDaniel
- Title
- President
- Phone
- (252) 523-9094
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Ability Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | HAL096001 | NC | Yes |
Addresses
Primary practice location
167 Fussell Rd
La Grange, NC 28551-7745
Mailing address
PO Box 428
La Grange, NC 28551-0428
Phone (252) 566-4112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7806624 | Medicaid | NC | |
| 7801106 | Medicaid | NC | |
| W1265264509 | Other | NC | BC/BS OF NC |
Other names
- LaGrange Gardens Assisted Living
Other providers in La Grange, NC
- Ant Mary'S Family Care
- Ant Mary'S Family Care #2
- Ant Marys Family Care Inc
- Jennifer Casey Baker
- Bellas Care LLC
- Cecil Raymond Burke III
- Country Pines Inc
- Country Pines Inc
- Daniel'S Choices Youth Development, Inc.
- Kyle Denton
All providers in La Grange, NC · Adult Care Home Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.