Provider Demographics
NPI:1134518038
Name:THE ADOLPHUS GROUP, LLC
Entity Type:Organization
Organization Name:THE ADOLPHUS GROUP, LLC
Other - Org Name:RIVERWOOD ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-386-8516
Mailing Address - Street 1:137 STRATFORD PL
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-8501
Mailing Address - Country:US
Mailing Address - Phone:336-466-0011
Mailing Address - Fax:
Practice Address - Street 1:711 W ATKINS ST
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-9027
Practice Address - Country:US
Practice Address - Phone:336-386-8516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL086014310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility