Organization
REDWOOD LTC GROUP, LLC
Active
Other names
Premier Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN G MCDANIEL (PRESIDENT)
(252) 523-9094
Entity
Organization
Contact information
Practice address
225 WHITE ST, JACKSONVILLE, NC 28546-6351
(910) 353-7222
(910) 353-8010
Mailing address
225 WHITE ST, JACKSONVILLE, NC 28546-6351
(910) 353-7222
(910) 353-8010
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0229
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00959
BC/BS OF NC
NC
05
—
3405217
—
NC
05
—
3415217
—
NC
05
—
7802298
—
NC
Enumeration date
06/18/2006
Last updated
07/09/2021
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