Organization
RALEIGH REHABILITATION CENTER, LLC
Active
Other names
Raleigh Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. R. MARK CRONQUIST (MANAGER)
(404) 574-2100
Entity
Organization
Contact information
Practice address
616 WADE AVE, RALEIGH, NC 27605-1237
(919) 828-6251
(919) 828-3294
Mailing address
5887 GLENRIDGE DR, SUITE 150, ATLANTA, GA 30328-5574
(404) 574-2100
(404) 574-2105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0115
NC
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396161527
—
NC
Enumeration date
03/12/2014
Last updated
09/29/2014
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