# VALDESE NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colleg Pines Health & Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699763904
- **Authorized official:** ROBERT FRITTS (SENIOR VICE PRESIDENT CFO)
- **Authorized official phone:** (828) 580-5545

## Contact information

- **Practice address:** 95 LOCUST ST, CONNELLY SPRINGS, NC 28612-8007
- **Practice address phone:** (828) 580-6800
- **Practice address fax:** (828) 580-6803
- **Mailing address:** PO BOX 250, VALDESE, NC 28690-0250
- **Mailing address phone:** (828) 580-6800
- **Mailing address fax:** (828) 580-6803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0553 | NC | Yes |

## Other

- **Enumeration date:** 10/11/2005
- **Last updated:** 10/13/2011

## 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 |