Organization
MAPLE LTC GROUP, LLC
Active
Other names
Carolina Rivers Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GALE BOICE (CFO)
(252) 523-9094
Entity
Organization
Contact information
Practice address
1839 ONSLOW DR. EXT., JACKSONVILLE, NC 28540
(910) 455-3610
(910) 455-3993
Mailing address
PO BOX 5021, JACKSONVILLE, NC 28540-1021
(910) 455-3610
(910) 455-3993
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00892
BLUE CROSS/BLUE SHIELD
NC
05
—
3425072
—
NC
05
—
3496587
—
NC
Enumeration date
07/07/2006
Last updated
07/14/2021
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