Provider Demographics
NPI:1932145836
Name:REDWOOD LTC GROUP, LLC
Entity Type:Organization
Organization Name:REDWOOD LTC GROUP, LLC
Other - Org Name:HARMONY HALL NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-523-9094
Mailing Address - Street 1:PO BOX 3527
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28502-3527
Mailing Address - Country:US
Mailing Address - Phone:252-523-0082
Mailing Address - Fax:252-523-5698
Practice Address - Street 1:312 WARREN AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-3840
Practice Address - Country:US
Practice Address - Phone:252-523-0082
Practice Address - Fax:252-523-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0355314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00901OtherBC/BS OF NC
NC3425156Medicaid
NC3415156Medicaid
NC3406286Medicaid
NC345156Medicare PIN