# WILLOW RIDGE OF NC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609886159
- **Authorized official:** MARCELLA GRAF (EXECUTIVE CONTROLLER)
- **Authorized official phone:** (224) 377-2400

## Contact information

- **Practice address:** 237 TRYON RD, RUTHERFORDTON, NC 28139-3058
- **Practice address phone:** (828) 286-7200
- **Practice address fax:** (828) 287-3668
- **Mailing address:** 237 TRYON RD, RUTHERFORDTON, NC 28139-3058
- **Mailing address phone:** (828) 286-7200
- **Mailing address fax:** (828) 287-3668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0590 | NC | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 02/26/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3435197 | — | NC |