Raintree Healthcare of Tabor City, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL024010 Issued in NC

Legal business name

RAINTREE HEALTHCARE OF TABOR CITY, LLC

Doing business as

Waterbrooke Assisted Living

Practice address

703 Elizabeth St
Tabor City, NC 28463-2603

Phone

(910) 653-6400

Fax

(910) 653-5081

NPI assigned

Jan 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Reema Owens

Title

Owner/Executive Director

Phone

(704) 763-6300

Specialties & licenses 1

Addresses

Other names 1

• Waterbrooke Assisted Living Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1578748414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668611",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282668611",
            "telephone_number": "910-653-6400",
            "fax_number": "803-631-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ELIZABETH ST",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284632603",
            "telephone_number": "910-653-6400",
            "fax_number": "910-653-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINTREE HEALTHCARE OF TABOR CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "REEMA",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-763-6300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL024010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterbrooke Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Tabor City, NC
• Providers in Tabor City, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.