Provider Demographics
NPI:1780672790
Name:CAROLINA ADVENTIST RETIREMENT SYSTEMS, INC.
Entity type:Organization
Organization Name:CAROLINA ADVENTIST RETIREMENT SYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-418-2334
Mailing Address - Street 1:95 HOLCOMBE COVE RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9450
Mailing Address - Country:US
Mailing Address - Phone:828-667-9851
Mailing Address - Fax:828-665-4666
Practice Address - Street 1:95 HOLCOMBE COVE RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9450
Practice Address - Country:US
Practice Address - Phone:828-667-9851
Practice Address - Fax:828-665-4666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0184314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405393Medicaid
NC0090JOtherBCBS PROVIDER ID
NC345393Medicare Oscar/Certification