Provider Demographics
NPI:1255488805
Name:EASTERN RETIREMENT CENTERS, INC
Entity Type:Organization
Organization Name:EASTERN RETIREMENT CENTERS, INC
Other - Org Name:AUTUMNFIELD OF BELHAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-964-2490
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-0459
Mailing Address - Country:US
Mailing Address - Phone:252-964-2490
Mailing Address - Fax:252-964-2494
Practice Address - Street 1:1345 SEED TICK NECK RD
Practice Address - Street 2:
Practice Address - City:PINETOWN
Practice Address - State:NC
Practice Address - Zip Code:27865-9325
Practice Address - Country:US
Practice Address - Phone:252-964-2490
Practice Address - Fax:252-964-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310400000X310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7802384Medicaid