Organization
EC OPCO SOUTHPORT LP
Active
Other names
ELMCROFT OF SOUTHPORT
Organization subpart
No
Provider details
NPI number
Authorized official
AMY W FLEMING (CONTROLLER FOR MANAGEMENT COMPANY)
(971) 227-3922
Entity
Organization
Contact information
Practice address
1125 E LEONARD ST, SOUTHPORT, NC 28461-8316
(910) 454-4001
(910) 454-0300
Mailing address
ELMCROFT OF SOUTHPORT, 5885 MEADOWS ROAD #500, LAKE OSWEGO, OR 97035
(971) 213-4234
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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