BIRCH LTC GROUP, LLC (NPI# 1265468441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265468441 |
Entity Type | Organization |
Organization Name | BIRCH LTC GROUP, LLC |
Other Organization Name | LAGRANGE GARDENS ASSISTED LIVING |
Practice Address |
167 Fussell Rd La Grange NC 28551-7745 |
Mailing Address |
Po Box 428 La Grange NC 28551-0428 |
Practice Telephone | 2525664112 |
Practice Fax Number | 2525662267 |
Mailing Telephone | 2525664112 |
Mailing Fax Number | 2525662267 |
Enumeration Date | 2006-06-23 |
Last Update Date | 2017-04-07 |
Authorized Official Name | MS. KAREN G MCDANIEL (PRESIDENT) |
Authorized Official Telephone | 2525239094 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
HAL096001 | NC | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BC/BS OF NC | W1265264509 | 01 |
NC | 7806624 | 05 | |
NC | 7801106 | 05 |
Other Name | Type Code |
---|---|
LaGrange Gardens Assisted Living | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225064777 | Birch Ltc Group, LLC | Skilled Nursing Facility | 515 Barbour Rd, Smithfield, NC 27577-7698 | 2006-06-25 |
1508802497 | Birch Ltc Group, LLC | Skilled Nursing Facility | 2401 Wayne Memorial Dr, Goldsboro, NC 27534-1727 | 2006-06-21 |
Street Address |
167 FUSSELL RD |
City | LA GRANGE |
State | NC |
Zip Code | 28551-7745 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992229215 | Christopher Webster | Physical Therapist | 3870 Falling Creek Road, Legrange, NC 28551 | 2017-07-28 |
1437527082 | Tanger Lee Jones | Counselor | 197 Brook Meadow Lane, Lagrange, NC 28551 | 2015-09-11 |
1235362161 | Daniel's Choices Youth Development, Inc. | Community/Behavioral Health | 525 Arba Jason Rd., La Grange, NC 28551 | 2009-08-26 |
1518942135 | Marjorie R Rachide | Nurse Practitioner | 101 South Carey Street, Lagrange, NC 28551 | 2005-12-07 |
1669611471 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 407 W. Washington Street, Lagrange, NC 28551-1623 | 2009-02-18 |
1447499330 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 405 W Washington St, La Grange, NC 28551-1623 | 2009-02-17 |
1629259676 | Advantage Care of North Carolina, LLC | Case Management | 111 S Caswell St, La Grange, NC 28551-1707 | 2007-11-19 |
1629118013 | Waters' Provider Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 W James St, La Grange, NC 28551-1727 | 2007-02-07 |
1568586808 | Ant Mary's Family Care | Custodial Care Facility | 127 E Railroad St, La Grange, NC 28551-1741 | 2007-03-19 |
1720063340 | Carl L Haynes Jr. | Family Medicine | 101 S Carey St, La Grange, NC 28551-1805 | 2005-12-07 |
Find all providers in zip 28551 |
Taxonomy Code | 311ZA0620X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Custodial Care Facility |
Specialization | Adult Care Home |
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023298718 | Ant Mary's Family Care Home #3 | Custodial Care Facility | 3713 Ed Herring Rd, La Grange, NC 28551-8331 | 2007-11-09 |
1386769040 | Ant Mary's Family Care #2 | Custodial Care Facility | 6198 Washington St, La Grange, NC 28551-6823 | 2007-03-20 |
1568586808 | Ant Mary's Family Care | Custodial Care Facility | 127 E Railroad St, La Grange, NC 28551-1741 | 2007-03-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on BIRCH LTC GROUP, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.