Basic Information
| Provider Information | |||||||||
| NPI: | 1013482314 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LARCHWOOD CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1667 | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286031667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283248898 | ||||||||
| FaxNumber: | 8283229598 | ||||||||
| Practice Location | |||||||||
| Address1: | 4110 ROCKY RIVER DR | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441351175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169416100 | ||||||||
| FaxNumber: | 2163777322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2018 | ||||||||
| LastUpdateDate: | 10/12/2018 | ||||||||
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| AuthorizedOfficialLastName: | THOMPSON | ||||||||
| AuthorizedOfficialFirstName: | LOWELL | ||||||||
| AuthorizedOfficialMiddleName: | PRENTICE | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2169529358 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | II | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.