Provider Demographics
NPI:1467421024
Name:UNIVERSAL HEALTH CARE / RALEIGH, INC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH CARE / RALEIGH, INC
Other - Org Name:LITCHFORD FALLS HEALTH & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-633-0055
Mailing Address - Street 1:8200 LITCHFORD RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4231
Mailing Address - Country:US
Mailing Address - Phone:919-878-7772
Mailing Address - Fax:919-878-0950
Practice Address - Street 1:8200 LITCHFORD RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4231
Practice Address - Country:US
Practice Address - Phone:919-878-7772
Practice Address - Fax:919-878-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0558314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405499Medicaid
NC7803945Medicaid
NC340612WMedicaid
NC7100016OtherEVERCARE PROVIDER NUMBER
NC009A1OtherBCBS PROVIDER NUMBER
NC345499Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER