Provider Demographics
NPI:1447568167
Name:WRIGHTSVILLE HEALTH HOLDINGS, LLC
Entity Type:Organization
Organization Name:WRIGHTSVILLE HEALTH HOLDINGS, LLC
Other - Org Name:NEW HANOVER HEALTH AND REHABILITATION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:TREFZGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-261-7312
Mailing Address - Street 1:PO BOX 9268
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-9268
Mailing Address - Country:US
Mailing Address - Phone:828-322-3167
Mailing Address - Fax:828-322-3704
Practice Address - Street 1:221 SUMMER REST RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4135
Practice Address - Country:US
Practice Address - Phone:910-256-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0069314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC345368Medicare Oscar/Certification