Organization
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Active
Other names
Croasdaile Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN P ERICKSON (ASSISTANT SECRETARY)
(919) 384-3001
Entity
Organization
Contact information
Practice address
2600 CROASDAILE FARM PKWY, DURHAM, NC 27705-1331
(919) 384-2000
(919) 384-2480
Mailing address
2600 CROASDAILE FARM PARKWAY, DURHAM, NC 27705-1331
(919) 384-2000
(919) 384-2480
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00880
BCBS
NC
05
—
3405501
—
NC
05
—
340612Y
—
NC
Enumeration date
11/30/2005
Last updated
03/06/2017
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