Provider Demographics
NPI:1972641199
Name:SPRINGVIEW SENIOR LIVING INC
Entity Type:Organization
Organization Name:SPRINGVIEW SENIOR LIVING INC
Other - Org Name:SPRINGVIEW ASSISTED LIVING CROUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:DIX
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-222-8913
Mailing Address - Street 1:PO BOX 2175
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-2175
Mailing Address - Country:US
Mailing Address - Phone:336-222-8913
Mailing Address - Fax:336-222-1935
Practice Address - Street 1:613 W WHITSETT ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-1635
Practice Address - Country:US
Practice Address - Phone:336-222-8913
Practice Address - Fax:336-222-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL001025310400000X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7803938Medicaid
NCHAL-001-162OtherNC DIVISION OF HEALTH SERVICE REGULATION