# SPRUCE LTC GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethany Woods Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235175175
- **Authorized official:** GALE BOICE (CFO)
- **Authorized official phone:** (252) 523-9094

## Contact information

- **Practice address:** 33426 OLD SALISBURY RD, ALBEMARLE, NC 28001-8342
- **Practice address phone:** (704) 983-1195
- **Practice address fax:** (704) 982-0446
- **Mailing address:** PO BOX 1250, 33426 OLD SALISBURY ROAD, ALBEMARLE, NC 28002-1250
- **Mailing address phone:** (704) 983-1195
- **Mailing address fax:** (704) 982-0446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0462 | NC | Yes |

## Other

- **Enumeration date:** 06/21/2006
- **Last updated:** 07/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0096L | BLUE CROSS/BLUE SHIELD | NC |
| 05 | — | 3406509 | — | NC |
| 05 | — | 3425146 | — | NC |