Organization
TAR RIVER LTC GROUP, LLC
Active
Other names
Chowan River Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN G MCDANIEL (PRESIDENT)
(252) 523-9094
Entity
Organization
Contact information
Practice address
1341 PARADISE RD, EDENTON, NC 27932-8503
(252) 482-7481
(252) 482-7674
Mailing address
PO BOX 566, EDENTON, NC 27932-0566
(252) 482-7481
(252) 482-7674
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
NH0369
NC
314000000X
Skilled Nursing Facility
Primary
NH0369
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00809
BC/BS OF NC
NC
05
—
3425164
—
NC
05
—
7802461
—
NC
Enumeration date
06/18/2006
Last updated
07/14/2021
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