Provider Demographics
NPI:1881813897
Name:SENIOR CARE OF ORANGE COUNTY, INC.
Entity type:Organization
Organization Name:SENIOR CARE OF ORANGE COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-245-2017
Mailing Address - Street 1:105 MEADOWLANDS DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8500
Mailing Address - Country:US
Mailing Address - Phone:919-245-2017
Mailing Address - Fax:919-245-2018
Practice Address - Street 1:105 MEADOWLAND DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278
Practice Address - Country:US
Practice Address - Phone:919-245-2017
Practice Address - Fax:919-245-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408334Medicaid