EAGLE PEAK LTC GROUP, LLC (NPI# 1821024274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821024274 |
| Entity Type | Organization |
| Organization Name | EAGLE PEAK LTC GROUP, LLC |
| Other Organization Name | ENFIELD OAKS NURSING AND REHABILITATION CENTER |
| Practice Address |
208 Cary St Enfield NC 27823-1204 |
| Mailing Address |
1435 Highway 258n Kinston NC 28504-7208 |
| Practice Telephone | 2524452111 |
| Practice Fax Number | 2524455646 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | MS. GALE BOICE (CFO) |
| Authorized Official Telephone | 2525239094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH0037 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3415101 | 05 | |
| NC | 3416559 | 05 | |
| NC | 3425101 | 05 | |
| NC | BC/BS OF NC | 0085D | 01 |
| NC | STATE HEALTH PLAN | 91-0085D | 01 |
| Other Name | Type Code |
|---|---|
| Enfield Oaks Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376570275 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1704 Nc Hwy 39 North, Louisburg, NC 27549 | 2006-06-27 |
| 1184650541 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1016 Fletcher St, Wilkesboro, NC 28697-9472 | 2006-06-25 |
| 1972547321 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2006-06-16 |
| 1669657755 | Eagle Peak Ltc Group, LLC | Nursing Facility/Intermediate Care Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2008-01-08 |
| Street Address |
208 CARY ST |
| City | ENFIELD |
| State | NC |
| Zip Code | 27823-1204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326206061 | Janet W. Harper | Physical Therapy Assistant | 208 Cary St, Enfield, NC 27823-1204 | 2008-05-29 |
| 1912165648 | Frank S Harper | Physical Therapist | 208 Cary St, Enfield, NC 27823-1204 | 2008-05-29 |
| 1326235755 | Enfield Care, Inc. | Nursing Facility/Intermediate Care Facility | 208 Cary St, Enfield, NC 27823-1204 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548512346 | Nicky Miqueal Silver | Counselor | 14495 Hwy 301 N, Enfield, NC 27823 | 2012-10-04 |
| 1689934077 | Supreme Teens, L&c | Counselor | 14495 Hwy 301 N., Enfield, NC 27823 | 2012-05-21 |
| 1598836298 | Dixie Rest Home 2 | Assisted Living Facility | 311 East Bryant Street, Enfield, NC 27823 | 2006-11-13 |
| 1417028135 | Dixie Rest Home 1 | Assisted Living Facility | 310 North Martin Luther King Avenue, Enfield, NC 27823 | 2006-11-13 |
| 1144351503 | Halifax Medical Services, Inc | Clinic/Center | 114 Market St, Enfield, NC 27823-0339 | 2007-03-08 |
| 1568516235 | Life, Inc. | Intermediate Care Facility, Mentally Retarded | 214 Mcfarland Rd, Enfield, NC 27823-1128 | 2007-01-22 |
| 1609019678 | New Hope Family and Youth Services, LLC | Community/Behavioral Health | 102 S. West Railroad St., Enfield, NC 27823-1300 | 2009-04-07 |
| 1306908900 | Carolina Behavioral Care | Psychiatry & Neurology | 107 N Dennis Street, Enfield, NC 27823-1311 | 2006-12-14 |
| 1467455444 | Thomas Champion Drew Iv | Dentist | 117 Glenview Rd, Enfield, NC 27823-1324 | 2005-05-24 |
| 1891901534 | Thomas C Drew,iv,dds,pa | Dentist | 117 Glenview Rd, Enfield, NC 27823-1324 | 2007-05-16 |
| Find all providers in zip 27823 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346283587 | Petersen Health & Wellness, LLC | Skilled Nursing Facility | 408 N. Wilson, Box 285, Enfield, IL 62835 | 2006-06-14 |
| 1043209570 | Parkway Pavilion Healthcare | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4329 | 2005-10-18 |
| 1205839065 | Health Care Alliance, Inc D/b/a/ Blair Manor | Skilled Nursing Facility | 612 Hazard Ave, Enfield, CT 06082-4225 | 2005-05-24 |
| 1821541194 | Wv-parkway Pavilion LLC | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4367 | 2016-08-03 |
| 1407274103 | Ch-parkway Pavillion LLC | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4367 | 2014-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063756 | Cary Senior Housing I Opco, LLC | Skilled Nursing Facility | 221 Brightmore Dr, Cary, NC 27518-8145 | 2019-10-04 |
| 1629535455 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 621 Chestnut Ridge Pkwy, Blowing Rock, NC 28605-8962 | 2019-02-28 |
| 1871063214 | Vero Health X, LLC | Skilled Nursing Facility | 417 Cloverdale Rd, Sylva, NC 28779-0679 | 2018-11-28 |
| 1821573809 | Carolina Bay Healthcare Center of Wilmington, LLC | Skilled Nursing Facility | 740 Diamond Shoals Rd, Wilmington, NC 28403-4388 | 2018-09-26 |
| 1093228397 | Bellarose Nursing and Rehab Center, Inc. | Skilled Nursing Facility | 200 Bellarose Lake Way, Garner, NC 27529-7049 | 2017-11-08 |
| 1558872333 | Brunswick Health & Rehab Center, LLC | Skilled Nursing Facility | 9600 No 5 School Rd Nw, Ash, NC 28420-2122 | 2017-10-19 |
| 1538684212 | Eagle Acquisition Vi LLC | Skilled Nursing Facility | 901 S Halstead Blvd., Elizabeth City, NC 27909-6920 | 2017-08-03 |
| 1982130811 | Ashton Health and Rehabilitation, LLC | Skilled Nursing Facility | 5533 Burlington Rd, Mc Leansville, NC 27301-9622 | 2017-05-11 |
| 1831625037 | Supplemental Healthcare | Skilled Nursing Facility | 319 Vancouver Drive, Apartment 38g, Fayetteville, NC 28303 | 2017-05-08 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
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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.