# MAPLE LTC GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carolina Rivers Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558393835
- **Authorized official:** GALE BOICE (CFO)
- **Authorized official phone:** (252) 523-9094

## Contact information

- **Practice address:** 1839 ONSLOW DR. EXT., JACKSONVILLE, NC 28540
- **Practice address phone:** (910) 455-3610
- **Practice address fax:** (910) 455-3993
- **Mailing address:** PO BOX 5021, JACKSONVILLE, NC 28540-1021
- **Mailing address phone:** (910) 455-3610
- **Mailing address fax:** (910) 455-3993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0370 | NC | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 07/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00892 | BLUE CROSS/BLUE SHIELD | NC |
| 05 | — | 3425072 | — | NC |
| 05 | — | 3496587 | — | NC |