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Organization
SH1 CARMEL OPCO LLC
Active
Organization
SH1 CARMEL OPCO LLC
Active
Other names
The Pines on Carmel Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI BAKER (FINANCE AND LICENSING COORDINATOR)
(503) 998-5810
Entity
Organization
Contact information
Practice address
5820 CARMEL RD, CHARLOTTE, NC 28226-8106
(704) 544-4979
(704) 540-7883
Mailing address
5101 NE 82ND AVE STE 200, VANCOUVER, WA 98662-6343
(360) 254-9442
(360) 254-1770
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PE-EHE5B2A5K
—
NC
05
—
TBD
—
NC
Enumeration date
10/25/2021
Last updated
12/08/2021
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