Organization · NPI-2

Carolina Bay Healthcare Center Of Wilmington, LLC

Skilled Nursing Facility · Wilmington, NC

NPI number1821573809
StatusActive
Last updated in NPPESMar 5, 2020

Details

NPI
1821573809
Entity type
Organization (NPI-2)
Legal business name
Carolina Bay Healthcare Center Of Wilmington, LLC
Organization subpart
No
Enumeration date
Sep 26, 2018
Certification date
Mar 5, 2020
Last updated
Mar 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility––Yes

Other names

  • Bradley Creek Health Center (Doing Business As)

Practice location

740 Diamond Shoals Rd
Wilmington, NC 28403-4388

Phone 910-769-7500 · Fax 910-769-7573

Mailing address

2334 41st St
Wilmington, NC 28403-5502

Phone 910-815-3122

Authorized official

Jeffrey Wilson
Coo
9108153122

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