Provider Demographics
NPI:1770649493
Name:APPLEWOOD ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:APPLEWOOD ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:D
Authorized Official - Last Name:TITUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-236-4085
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ELM CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27822-0100
Mailing Address - Country:US
Mailing Address - Phone:252-236-4085
Mailing Address - Fax:252-236-3596
Practice Address - Street 1:416 N PARKER ST
Practice Address - Street 2:
Practice Address - City:ELM CITY
Practice Address - State:NC
Practice Address - Zip Code:27822-9217
Practice Address - Country:US
Practice Address - Phone:252-236-4085
Practice Address - Fax:252-236-3596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL098-019311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home