Provider Demographics
NPI:1942336425
Name:AMERICA'S LIVING CENTER WNC LLC
Entity Type:Organization
Organization Name:AMERICA'S LIVING CENTER WNC LLC
Other - Org Name:DRUID HILLS LIVING CENTER # 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-738-3046
Mailing Address - Street 1:1744 MEADOWBROOK TER
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-2328
Mailing Address - Country:US
Mailing Address - Phone:828-693-4171
Mailing Address - Fax:828-692-5203
Practice Address - Street 1:1744 MEADOWBROOK TER
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2328
Practice Address - Country:US
Practice Address - Phone:828-693-4171
Practice Address - Fax:828-692-5203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL045071310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7804732Medicaid