# BLUE RIDGE OF RALEIGH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blue Ridge Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508127861
- **Authorized official:** ANDROSKY ALBERTO LUGO ESQ. (EXECUTIVE VICE PRESIDENT AND G.C.)
- **Authorized official phone:** (201) 242-4006

## Contact information

- **Practice address:** 3830 BLUE RIDGE RD, RALEIGH, NC 27612-4319
- **Practice address phone:** (919) 781-4900
- **Practice address fax:** (919) 571-2583
- **Mailing address:** 3830 BLUE RIDGE RD, RALEIGH, NC 27612-4319
- **Mailing address phone:** (919) 781-4900
- **Mailing address fax:** (919) 571-2583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0428 | NC | Yes |

## Other

- **Enumeration date:** 06/04/2012
- **Last updated:** 06/04/2012