Organization
RV NURSING HOME, LLC
Active
Other names
Rich Square Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES T JOHNSON JR. (OWNER)
(252) 209-6834
Entity
Organization
Contact information
Practice address
320 NORTH MAIN STREET, RICH SQUARE, NC 27869-0560
(252) 539-4161
(252) 539-4361
Mailing address
320 NORTH MAIN STREET, P O BOX 560, RICH SQUARE, NC 27869-0560
(252) 539-4161
(252) 539-4361
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3425356
—
NC
05
—
3426020
—
NC
01
—
923433
FACILITY ID NUMBER
NC
Enumeration date
11/29/2006
Last updated
07/16/2007
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