Organization
WP-EDENTON HEALTH HOLDINGS, LLC
Active
Other names
Edenton House
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E TREFZGER (MANAGER)
(828) 322-5535
Entity
Organization
Contact information
Practice address
323 MEDICAL ARTS DR, EDENTON, NC 27932-8608
(252) 482-1113
(252) 482-3273
Mailing address
PO BOX 2568, HICKORY, NC 28603-2568
(828) 322-5535
(828) 326-8115
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
HAL-021-009
NC
311ZA0620X
Adult Care Home Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
12/28/2012
Last updated
10/11/2021
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