Provider Demographics
NPI:1306372230
Name:CAMDEN HEALTH AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:CAMDEN HEALTH AND REHABILITATION, LLC
Other - Org Name:CAMDEN HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SPRENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-608-9123
Mailing Address - Street 1:1 MARITHE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2702
Mailing Address - Country:US
Mailing Address - Phone:336-852-9700
Mailing Address - Fax:919-882-9771
Practice Address - Street 1:1 MARITHE CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2702
Practice Address - Country:US
Practice Address - Phone:336-852-9700
Practice Address - Fax:919-882-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0624314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405547Medicaid
NC34D1104341OtherCLIA
NCNC-AA 0000 3834OtherNORTH CAROLINA CONTROLLED SUBSTANCES REGISTRATION NUMBER
NCNC-AA 0000 3834OtherNORTH CAROLINA CONTROLLED SUBSTANCES REGISTRATION NUMBER
NC3405547Medicaid