Provider Demographics
NPI:1467757864
Name:REALITY RESIDENTIAL HENDERSONVILLE
Entity Type:Organization
Organization Name:REALITY RESIDENTIAL HENDERSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WITTNER
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-216-7475
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-0250
Mailing Address - Country:US
Mailing Address - Phone:828-693-4171
Mailing Address - Fax:828-692-5203
Practice Address - Street 1:1744 MEADOWBROOK TER
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2328
Practice Address - Country:US
Practice Address - Phone:828-693-4171
Practice Address - Fax:828-692-5203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-045-109310400000X
NCHAL-045-108310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility