# KINGSWOOD NURSING CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KingsWood Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134121106
- **Authorized official:** ROBERT HAGAN (PRESIDENT)
- **Authorized official phone:** (770) 993-4000

## Contact information

- **Practice address:** 797 PEE DEE RD, ABERDEEN, NC 28315-3830
- **Practice address phone:** (910) 944-8999
- **Practice address fax:** (910) 944-0809
- **Mailing address:** 995 CANTON ST STE 100, ROSWELL, GA 30075-4240
- **Mailing address phone:** (770) 993-4000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/18/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3415509 | — | NC |