Provider Demographics
NPI:1649396698
Name:RICHLAND COMMUNITY CARE 1&2
Entity Type:Organization
Organization Name:RICHLAND COMMUNITY CARE 1&2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR OF BRO
Authorized Official - Phone:828-452-0456
Mailing Address - Street 1:290 KILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-4264
Mailing Address - Country:US
Mailing Address - Phone:828-452-0456
Mailing Address - Fax:828-452-0114
Practice Address - Street 1:290 KILLIAN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-4264
Practice Address - Country:US
Practice Address - Phone:828-452-0456
Practice Address - Fax:828-452-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-044-027311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHAL-044-027Medicaid
NC7804962OtherPROVIDER #