Provider Demographics
NPI:1174167381
Name:CAROLINAS ALLIANCE FOR RESIDENTIAL EXCELLENCE - ELKIN LLC
Entity type:Organization
Organization Name:CAROLINAS ALLIANCE FOR RESIDENTIAL EXCELLENCE - ELKIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:REAVIS WARE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-408-5008
Mailing Address - Street 1:430 PINEOLA ST STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-7603
Mailing Address - Country:US
Mailing Address - Phone:855-677-1188
Mailing Address - Fax:855-677-1189
Practice Address - Street 1:500 JOHNSON RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2420
Practice Address - Country:US
Practice Address - Phone:855-677-1188
Practice Address - Fax:855-677-1189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINAS ALLIANCE FOR RESIDENTIAL EXCELLENCE HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home