Provider Demographics
NPI:1538500905
Name:BURLINGTON CARE CENTER
Entity Type:Organization
Organization Name:BURLINGTON CARE CENTER
Other - Org Name:LANE ST RETIREMENT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-229-9900
Mailing Address - Street 1:PO BOX 4094
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-0901
Mailing Address - Country:US
Mailing Address - Phone:336-229-9900
Mailing Address - Fax:336-584-5533
Practice Address - Street 1:625 LANE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2473
Practice Address - Country:US
Practice Address - Phone:336-229-9900
Practice Address - Fax:336-584-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-001-149311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home