Organization
BRITTHAVEN, INC.
Active
Other names
LAKE PARK NURSING & REHAB CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORWOOD RANDOLPH UZZELL (PRESIDENT)
(252) 523-9094
Entity
Organization
Contact information
Practice address
3315 FAITH CHURCH RD, INDIAN TRAIL, NC 28079-9300
(704) 882-3420
(704) 882-5197
Mailing address
PO BOX 2518, INDIAN TRAIL, NC 28079-2518
(704) 882-3420
(704) 882-5197
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0592
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340613B
—
NC
Enumeration date
10/01/2007
Last updated
10/01/2007
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