Provider Demographics
NPI:1457332876
Name:ARDENWOODS LLC
Entity Type:Organization
Organization Name:ARDENWOODS LLC
Other - Org Name:ARDENWOODS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUXO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4500
Mailing Address - Street 1:2400 APPALACHIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8327
Mailing Address - Country:US
Mailing Address - Phone:808-684-0041
Mailing Address - Fax:
Practice Address - Street 1:2400 APPALACHIAN BLVD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8327
Practice Address - Country:US
Practice Address - Phone:828-684-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-011-151310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility