Provider Demographics
NPI:1285866319
Name:ESLIKER-SAMUELS INC
Entity Type:Organization
Organization Name:ESLIKER-SAMUELS INC
Other - Org Name:THE MANOR AT EDGEWATER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESLIKER-SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-264-0775
Mailing Address - Street 1:5812 SNOOKS TRAIL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-8423
Mailing Address - Country:US
Mailing Address - Phone:919-264-0775
Mailing Address - Fax:844-384-9849
Practice Address - Street 1:1038 STORMY LANE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6074
Practice Address - Country:US
Practice Address - Phone:919-264-0775
Practice Address - Fax:844-384-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-092-153177F00000X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No177F00000XOther Service ProvidersLodgingGroup - Single Specialty