# GRANITE FALLS LTC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University Place Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669408969
- **Authorized official:** MS. KAREN G MCDANIEL (PRESIDENT)
- **Authorized official phone:** (252) 523-9094

## Contact information

- **Practice address:** 9200 GLENWATER DR, CHARLOTTE, NC 28262-8557
- **Practice address phone:** (704) 549-0807
- **Practice address fax:** (704) 548-8413
- **Mailing address:** PO BOX 561869, CHARLOTTE, NC 28256-1869
- **Mailing address phone:** (704) 549-0807
- **Mailing address fax:** (704) 548-8413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0016 | NC | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 07/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0096Q | BC/BS OF NC | NC |
| 01 | — | 24367 | PARTNERS INSURANCE | NC |
| 05 | — | 3415142 | — | NC |
| 05 | — | 3425142 | — | NC |
| 05 | — | 7801034 | — | NC |