Provider Demographics
NPI:1437110913
Name:SNUG HARBOR MANAGEMENT LLC
Entity Type:Organization
Organization Name:SNUG HARBOR MANAGEMENT LLC
Other - Org Name:SNUG HARBOR ON NELSON BAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:AUSBAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-225-4411
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:SEA LEVEL
Mailing Address - State:NC
Mailing Address - Zip Code:28577
Mailing Address - Country:US
Mailing Address - Phone:252-225-4411
Mailing Address - Fax:252-225-1670
Practice Address - Street 1:272 HWY 70
Practice Address - Street 2:
Practice Address - City:SEA LEVEL
Practice Address - State:NC
Practice Address - Zip Code:28577
Practice Address - Country:US
Practice Address - Phone:252-225-4411
Practice Address - Fax:252-225-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-01
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0202310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3415521Medicaid
NC345521Medicare ID - Type Unspecified