Provider Demographics
NPI:1407152671
Name:UNITED CARE CENTER
Entity Type:Organization
Organization Name:UNITED CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ORBRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-222-1462
Mailing Address - Street 1:409 MILL ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-2226
Mailing Address - Country:US
Mailing Address - Phone:336-214-1257
Mailing Address - Fax:336-222-6078
Practice Address - Street 1:409 MILL ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-2226
Practice Address - Country:US
Practice Address - Phone:336-214-1257
Practice Address - Fax:336-222-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL0011143104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805021Medicaid