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Organization
MAPLE LTC GROUP, LLC
Active
Organization
MAPLE LTC GROUP, LLC
Active
Other names
Carolina Rivers Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GALE BOICE (CFO)
(252) 523-9094
Entity
Organization
Contact information
Practice address
1839 ONSLOW DR. EXT., JACKSONVILLE, NC 28540
(910) 455-3610
(910) 455-3993
Mailing address
PO BOX 5021, JACKSONVILLE, NC 28540-1021
(910) 455-3610
(910) 455-3993
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00892
BLUE CROSS/BLUE SHIELD
NC
05
—
3425072
—
NC
05
—
3496587
—
NC
Enumeration date
07/07/2006
Last updated
07/14/2021
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