Provider Demographics
NPI:1497087373
Name:RENCARE SOLUTIONS, INC
Entity Type:Organization
Organization Name:RENCARE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:REAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, MBA
Authorized Official - Phone:336-677-1188
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:416 E MAIN ST
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0579
Mailing Address - Country:US
Mailing Address - Phone:336-677-1188
Mailing Address - Fax:336-677-1522
Practice Address - Street 1:711 W ATKINS ST
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-9027
Practice Address - Country:US
Practice Address - Phone:336-386-8516
Practice Address - Fax:336-386-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-086-012310400000X
NCHAL-024-015311ZA0620X
NCHAL-012-040311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7806273Medicaid