Organization
AVANTE AT REIDSVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA WILSON (PRESIDENT)
(954) 987-7180
Entity
Organization
Contact information
Practice address
543 MAPLE AVE, REIDSVILLE, NC 27320-4627
(336) 342-1382
(336) 616-0868
Mailing address
4601 SHERIDAN STREET, SUITE 500, HOLLYWOOD, FL 33021-3439
(336) 342-1382
(336) 496-4080
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH0293
NC
314000000X
Skilled Nursing Facility
Primary
NH0293
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3435227
—
NC
05
—
3436230
—
NC
Enumeration date
10/26/2006
Last updated
11/14/2016
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