Organization
TRC OF LOUISBURG, INC.
Active
Other names
Louisburg Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK ELLEDGE (VICE PRESIDENT)
(336) 679-8852
Entity
Organization
Contact information
Practice address
114 SMOKETREE WAY, LOUISBURG, NC 27549-2117
(919) 496-6084
(919) 496-5458
Mailing address
PO BOX 589, LOUISBURG, NC 27549-0589
(919) 496-6084
(919) 496-5458
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL-035-003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801294
—
NC
Enumeration date
03/01/2006
Last updated
08/22/2020
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