Provider Demographics
NPI:1750418802
Name:ALAMANCE EXTENDED CARE, INC.
Entity type:Organization
Organization Name:ALAMANCE EXTENDED CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-570-8458
Mailing Address - Street 1:1860 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3200
Mailing Address - Country:US
Mailing Address - Phone:336-570-8456
Mailing Address - Fax:336-570-8460
Practice Address - Street 1:1860 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3200
Practice Address - Country:US
Practice Address - Phone:336-570-8456
Practice Address - Fax:336-570-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0596314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0015735Medicaid
NC39746OtherPARTNERS MEDICARE CHOICE
NC7805329Medicaid
NC00826OtherBLUE CROSS BLUE SHIELD
NC3416590Medicaid
NC3415091Medicaid
NC7100024OtherUNITED HEALTHCARE MEDICAR
NC345091Medicare Oscar/Certification
NC0015735Medicaid