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Organization
BIRCH LTC GROUP, LLC
Active
Organization
BIRCH LTC GROUP, LLC
Active
Other names
Willow Creek Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN G MCDANIEL (PRESIDENT)
(252) 523-9094
Entity
Organization
Contact information
Practice address
2401 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-1727
(919) 736-2121
(919) 736-2133
Mailing address
PO BOX 11419, GOLDSBORO, NC 27532-1419
(919) 736-2121
(919) 736-2133
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00898
BC/BS OF NC
NC
05
—
3415113
—
NC
05
—
3425113
—
NC
Enumeration date
06/21/2006
Last updated
07/09/2021
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