Organization
GRANITE FALLS LTC, LLC
Active
Other names
Jacob's Creek 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
1721 BALD HILL LOOP, MADISON, NC 27025-7624
(336) 548-9658
(336) 548-1299
Mailing address
1721 BALD HILL LOOP, MADISON, NC 27025-7624
(336) 548-9658
(336) 548-1299
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091B
BC/BS OF NC
NC
01
—
24380
PARTNERS INSURANCE
NC
05
—
3415050
—
NC
05
—
3425050
—
NC
01
—
561370182
UNITED HEALTHCARE #
NC
Enumeration date
06/23/2006
Last updated
07/14/2021
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