GLENCARE ASSISTED LIVING, INC. (NPI# 1679612642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679612642 |
| Entity Type | Organization |
| Organization Name | GLENCARE ASSISTED LIVING, INC. |
| Other Organization Name | GLENCARE OF HOLLY RIDGE |
| Practice Address |
3255 Sound Road Holy Ridge NC 28445-0157 |
| Mailing Address |
Po Box 339 Kenansville NC 28349-0339 |
| Practice Telephone | 9103299941 |
| Practice Fax Number | 9103299943 |
| Mailing Telephone | 9102750058 |
| Mailing Fax Number | 9102750093 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARIAN ANNE KORNEGAY (VICE PRESIDENT) |
| Authorized Official Telephone | 9102750058 |
| Authorized Official Credential | R.N. NHA V.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | HAL067015 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805699 | 05 |
| Other Name | Type Code |
|---|---|
| Glencare of Holly Ridge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679612188 | Glencare Assisted Living, Inc. | Assisted Living Facility | 2773 Pinewood Home Dr, Pink Hill, NC 28572-9555 | 2007-02-05 |
| Street Address |
3255 SOUND ROAD |
| City | HOLY RIDGE |
| State | NC |
| Zip Code | 28445-0157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790246304 | Christopher Burkett | Dietitian, Registered | Stone Bay Base Rr136, Fpo, AA 28445 | 2019-03-27 |
| 1154733707 | Valjoy Beach Care, P.a. | Physician Assistant | 204-d N New River Drive, Surf City, NC 28445 | 2014-05-29 |
| 1487078150 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 420 Fun Center Dr, Surf City, NC 28445 | 2014-02-14 |
| 1114272440 | Jennifer Nicole Buchanan | Pharmacist | 13500 Nc Hwy 50/210, Surf City, NC 28445 | 2012-07-24 |
| 1891027652 | Selena A Kennaday | Pharmacist | 420 Fun Center Drive, Walmart Pharmacy, Surf City, NC 28445 | 2010-02-04 |
| 1497964787 | Primary Vision Care Center, O.d., P.a. | Optometrist | 13520 Nc Hwy 50, Surf City, NC 28445 | 2007-05-22 |
| 1922120260 | Jim Lankford White | Dentist | 119 Holly Street, Holly Ridge, NC 28445 | 2007-04-06 |
| 1215082540 | Beach Care Pa | Nurse Practitioner | 204 D New River Drive, Surf City, NC 28445 | 2007-01-25 |
| 1023163748 | Sandra Thompson Brown | Counselor | 114 Dunes Ct., Surf City, NC 28445 | 2007-01-24 |
| 1972657302 | Family Urgent Care of America, Inc | Non-Pharmacy Dispensing Site | 502 North Highway 17, Holly Ridge, NC 28445 | 2007-01-23 |
| Find all providers in zip 28445 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629689104 | B&b Assisted Living Care LLC | Assisted Living Facility | 9461 Us Hwy 710s, Rowland, NC 28383 | 2020-08-10 |
| 1306465745 | Cedar Senior Living, LLC. | Assisted Living Facility | 670 Cedar Lake Ln, Clinton, NC 28328-8986 | 2020-04-15 |
| 1003444258 | Trinity Developmental Center, LLC | Assisted Living Facility | 4027 Franklin Meadows Dr, Matthews, NC 28105-6935 | 2020-03-31 |
| 1114562147 | Taylor Care Group, LLC | Assisted Living Facility | 1188 Bertha Wilson Rd, Blanch, NC 27212-9795 | 2019-11-13 |
| 1710528377 | Grace Village Inc | Assisted Living Facility | 501 River Bend Dr., Granite Falls, NC 28630 | 2019-10-04 |
| 1336799246 | Tieshquanna Ciare Richardson | Assisted Living Facility | 312 Kilgo St, Clayton, NC 27520-1651 | 2019-09-13 |
| 1326695404 | Snh Nc Tenant LLC | Assisted Living Facility | 5920 Mcchesney Dr, Charlotte, NC 28269-6238 | 2019-08-22 |
| 1659928174 | Coastal Pointe Senior Living LLC | Assisted Living Facility | 5220 Ocean Hwy W, Shallotte, NC 28470-4006 | 2019-08-20 |
| 1861046674 | A1a-arc of Dunn, LLC | Assisted Living Facility | 217 Jonesboro Rd, Dunn, NC 28334-6240 | 2019-07-30 |
| 1679137665 | Kenzi Care LLC | Assisted Living Facility | 668 Wood Rd, Taylorsville, NC 28681 | 2019-04-25 |
| Find all providers with the same taxonomy | ||||
| City | HOLY RIDGE |
| Zip Code | 28445 |
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| 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.