Provider Demographics
NPI:1073955456
Name:WOODLAND TERRACE FCH
Entity Type:Organization
Organization Name:WOODLAND TERRACE FCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-719-0230
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-0513
Mailing Address - Country:US
Mailing Address - Phone:828-505-3842
Mailing Address - Fax:828-505-3842
Practice Address - Street 1:12 ELLA LANE
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701-5506
Practice Address - Country:US
Practice Address - Phone:828-505-3842
Practice Address - Fax:828-505-3842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home