Provider Demographics
NPI:1851712863
Name:UNIVERSAL HEALTHCARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTHCARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:845-659-7478
Mailing Address - Street 1:301 S CHURCH ST
Mailing Address - Street 2:SUITE 136
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-5755
Mailing Address - Country:US
Mailing Address - Phone:252-454-0034
Mailing Address - Fax:888-273-8787
Practice Address - Street 1:301 S CHURCH ST
Practice Address - Street 2:SUITE 136
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5755
Practice Address - Country:US
Practice Address - Phone:252-454-0034
Practice Address - Fax:888-273-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities