# CAROLINAS ANSON HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lillie Bennett Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619963832
- **Authorized official:** MR. JOHN G MOORE (CFO)
- **Authorized official phone:** (704) 694-5131

## Contact information

- **Practice address:** 500 MORVEN RD, WADESBORO, NC 28170-2745
- **Practice address phone:** (704) 694-5131
- **Practice address fax:** (704) 694-3900
- **Mailing address:** 500 MORVEN RD, WADESBORO, NC 28170-2745
- **Mailing address phone:** (704) 694-5131
- **Mailing address fax:** (704) 694-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | H0082 | NC | Yes |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 09/13/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1315600001 | DURABLE MEDICAL EQUIPMENT | NC |
| 05 | — | 3415051 | — | NC |
| 05 | — | 3416531 | — | NC |