# SPRUCE LTC GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clear Creek Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710312079
- **Authorized official:** GALE BOICE (CFO)
- **Authorized official phone:** (252) 523-9094

## Contact information

- **Practice address:** 10506 CLEAR CREEK COMMERCE DR, MINT HILL, NC 28227-7078
- **Practice address phone:** (704) 545-2377
- **Practice address fax:** (252) 939-4254
- **Mailing address:** PO BOX 6249, KINSTON, NC 28501-0249
- **Mailing address phone:** (252) 523-9094
- **Mailing address fax:** (252) 939-4101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/05/2013
- **Last updated:** 07/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NH0635 | NURSING HOME LICENSE | NC |