Provider Demographics
NPI:1790966554
Name:ESLIKER-SAMUELS INC
Entity Type:Organization
Organization Name:ESLIKER-SAMUELS INC
Other - Org Name:THE MANOR AT COVENTRY CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESLIKER-SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-264-0775
Mailing Address - Street 1:5812 SNOOKS TRL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-8423
Mailing Address - Country:US
Mailing Address - Phone:919-264-0775
Mailing Address - Fax:844-384-9849
Practice Address - Street 1:5124 WERRIBEE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5546
Practice Address - Country:US
Practice Address - Phone:919-878-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-092-132177F00000X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No177F00000XOther Service ProvidersLodgingGroup - Single Specialty