Organization
BIRCH LTC GROUP, LLC
Active
Other names
Willow Creek Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN G MCDANIEL (PRESIDENT)
(252) 523-9094
Entity
Organization
Contact information
Practice address
2401 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-1727
(919) 736-2121
(919) 736-2133
Mailing address
PO BOX 11419, GOLDSBORO, NC 27532-1419
(919) 736-2121
(919) 736-2133
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00898
BC/BS OF NC
NC
05
—
3415113
—
NC
05
—
3425113
—
NC
Enumeration date
06/21/2006
Last updated
07/09/2021
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