Provider Demographics
NPI:1780653428
Name:BN HEALTHCARE, LLC
Entity Type:Organization
Organization Name:BN HEALTHCARE, LLC
Other - Org Name:BRIGHTON MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-633-0055
Mailing Address - Street 1:415 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2147
Mailing Address - Country:US
Mailing Address - Phone:919-552-5609
Mailing Address - Fax:919-567-0526
Practice Address - Street 1:415 SUNSET DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2147
Practice Address - Country:US
Practice Address - Phone:919-552-5609
Practice Address - Fax:919-567-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0193314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3415382Medicaid
NC7801834Medicaid
NC009APOtherBCBS PROVIDER NUMBER
NC3426106Medicaid
NC7100055OtherEVERCARE PROVIDER NUMBER
NC7100055OtherEVERCARE PROVIDER NUMBER