# RV ASSISTED LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rich Square Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912144601
- **Authorized official:** CHARLES E TREFZGER (MANAGER)
- **Authorized official phone:** (828) 322-5535

## Contact information

- **Practice address:** 400 NORTH MAIN STREET, RICH SQUARE, NC 27869-9568
- **Practice address phone:** (252) 539-4145
- **Practice address fax:** (252) 539-2479
- **Mailing address:** PO BOX 2568, HICKORY, NC 28603-2568
- **Mailing address phone:** (828) 322-5535
- **Mailing address fax:** (828) 326-8115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 311500000X | Alzheimer Center (Dementia Center) | HAL-066-011 | NC | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 01/16/2009
- **Last updated:** 10/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805825 | — | NC |