Organization
CONCORD HEALTH CARE LP
Active
Other names
The Country Home
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HODGES (MEMBER MANAGER)
(828) 738-3046
Entity
Organization
Contact information
Practice address
2908 COUNTRY HOME RD, CONCORD, NC 28025-7628
(704) 782-5288
(704) 782-5304
Mailing address
2908 COUNTRY HOME RD, CONCORD, NC 28025-7628
(704) 782-5288
(704) 782-5304
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL013012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805645
—
NC
Enumeration date
02/23/2007
Last updated
08/22/2020
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