Provider Demographics
NPI:1043087026
Name:RIDGELINE NEW BERN LLC
Entity Type:Organization
Organization Name:RIDGELINE NEW BERN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT TO CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-745-8277
Mailing Address - Street 1:2095 SUMMER LEE DR STE 207
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5438
Mailing Address - Country:US
Mailing Address - Phone:469-745-8277
Mailing Address - Fax:
Practice Address - Street 1:4522 OLD CHERRY POINT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-8012
Practice Address - Country:US
Practice Address - Phone:252-634-9066
Practice Address - Fax:252-634-1862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility