# WILORA LAKE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilora Lake Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215979059
- **Authorized official:** TIM LEHNER (MANAGER)
- **Authorized official phone:** (770) 698-9040

## Contact information

- **Practice address:** 6001 WILORA LAKE RD, CHARLOTTE, NC 28212-2833
- **Practice address phone:** (704) 563-2922
- **Practice address fax:** (704) 563-2814
- **Mailing address:** 6001 WILORA LAKE RD, CHARLOTTE, NC 28212-2833
- **Mailing address phone:** (704) 563-2922
- **Mailing address fax:** (704) 563-2814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH572 | NC | Yes |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 09/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1215979059 | — | NC |