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Organization
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Active
Organization
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Active
Other names
Croasdaile Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN P ERICKSON (ASSISTANT SECRETARY)
(919) 384-3001
Entity
Organization
Contact information
Practice address
2600 CROASDAILE FARM PKWY, DURHAM, NC 27705-1331
(919) 384-2000
(919) 384-2480
Mailing address
2600 CROASDAILE FARM PARKWAY, DURHAM, NC 27705-1331
(919) 384-2000
(919) 384-2480
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00880
BCBS
NC
05
—
3405501
—
NC
05
—
340612Y
—
NC
Enumeration date
11/30/2005
Last updated
03/06/2017
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