Organization
FOREST RIDGE ASSISSTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN E BAILEY CFO (MEMBER MANAGER)
(336) 993-7555
Entity
Organization
Contact information
Practice address
151 VILLAGE PARK DR, WEST JEFFERSON, NC 28694-6015
(336) 846-1008
Mailing address
151 VILLAGE PARK DR, WEST JEFFERSON, NC 28694-6015
(336) 846-1008
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-005-015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
NC
Enumeration date
07/19/2012
Last updated
07/19/2012
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