Provider Demographics
NPI:1598910978
Name:ADVOCARE OF NORTH CAROLINA, INC
Entity Type:Organization
Organization Name:ADVOCARE OF NORTH CAROLINA, INC
Other - Org Name:MAGNOLIA GARDENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:8645-778-6599
Mailing Address - Street 1:3720 BOILING SPRINGS RD
Mailing Address - Street 2:SUITE F, PMB 103
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5716
Mailing Address - Country:US
Mailing Address - Phone:864-578-6599
Mailing Address - Fax:864-814-1198
Practice Address - Street 1:5935 MOUNT SINAI RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-8616
Practice Address - Country:US
Practice Address - Phone:919-489-2361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0093314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3436018Medicaid
NC3425346Medicaid