Basic Information
Provider Information
NPI: 1649817859
EntityType: 2
ReplacementNPI:  
OrganizationName: RHCSC SOCIAL CIRCLE HEALTH HOLDINGS LLC
LastName:  
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Mailing Information
Address1: PO BOX 2568
Address2:  
City: HICKORY
State: NC
PostalCode: 286032568
CountryCode: US
TelephoneNumber: 8282700651
FaxNumber:  
Practice Location
Address1: 621 N CHEROKEE RD
Address2:  
City: SOCIAL CIRCLE
State: GA
PostalCode: 300252877
CountryCode: US
TelephoneNumber: 7704644211
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/06/2019
LastUpdateDate: 12/06/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: TREFZGER
AuthorizedOfficialFirstName: CHARLES
AuthorizedOfficialMiddleName: E
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 8283225535
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
310400000X  Y Nursing & Custodial Care FacilitiesAssisted Living Facility 

No ID Information.


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