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Organization
VALDESE NURSING HOME INC
Active
Organization
VALDESE NURSING HOME INC
Active
Other names
Colleg Pines Health & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FRITTS (SENIOR VICE PRESIDENT CFO)
(828) 580-5545
Entity
Organization
Contact information
Practice address
95 LOCUST ST, CONNELLY SPRINGS, NC 28612-8007
(828) 580-6800
(828) 580-6803
Mailing address
PO BOX 250, VALDESE, NC 28690-0250
(828) 580-6800
(828) 580-6803
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0553
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090P
BCBS NC PROVIDER
NC
05
—
3405446
—
NC
05
—
340606A
—
NC
01
—
923110
FACILITY ID NUMBER
NC
Enumeration date
10/11/2005
Last updated
10/13/2011
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