Organization
SPRUCE LTC GROUP, LLC
Active
Other names
Clear Creek 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
10506 CLEAR CREEK COMMERCE DR, MINT HILL, NC 28227-7078
(704) 545-2377
(252) 939-4254
Mailing address
PO BOX 6249, KINSTON, NC 28501-0249
(252) 523-9094
(252) 939-4101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NH0635
NURSING HOME LICENSE
NC
Enumeration date
09/05/2013
Last updated
07/16/2021
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