Provider Demographics
NPI:1649590498
Name:SENIOR CARE PROPERTIES, INC.
Entity Type:Organization
Organization Name:SENIOR CARE PROPERTIES, INC.
Other - Org Name:HARBORVIEW REHAB AND HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GATEWOOD,
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:252-726-6855
Mailing Address - Street 1:812 SHEPARD ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4250
Mailing Address - Country:US
Mailing Address - Phone:252-726-6855
Mailing Address - Fax:252-808-2074
Practice Address - Street 1:812 SHEPARD ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4250
Practice Address - Country:US
Practice Address - Phone:252-726-6855
Practice Address - Fax:252-808-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0255314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00982OtherBLUE CROSS BLUE SHIELD
NC3405244Medicaid
NC345244Medicare Oscar/Certification