Organization
RV ASSISTED LIVING, LLC
Active
Other names
Rich Square Villa
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E TREFZGER (MANAGER)
(828) 322-5535
Entity
Organization
Contact information
Practice address
310 NORTH MAIN STREET, RICH SQUARE, NC 27869-9568
(252) 539-2011
(252) 539-2317
Mailing address
PO BOX 2568, HICKORY, NC 28603-2568
(828) 322-5535
(828) 326-8115
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
HAL-066-010
NC
311ZA0620X
Adult Care Home Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805824
—
NC
Enumeration date
01/20/2009
Last updated
10/11/2021
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