GLENCARE ASSISTED LIVING INC. NPI 1679612642

NPI Information

  • NPI: 1679612642
  • Provider Name: GLENCARE ASSISTED LIVING, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: GLENCARE OF HOLLY RIDGE
  • Address: 3255 SOUND ROAD
    HOLY RIDGE, NC
    ZIP 28445
  • Phone: (910) 329-9941

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NPI Details

GLENCARE ASSISTED LIVING, INC. is an assisted living facility in Holy Ridge, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GLENCARE ASSISTED LIVING, INC. NPI is 1679612642. The provider is registered as an organization entity type.
The provider Is Doing Business As Glencare Of Holly Ridge.

The provider's business location address is:

3255 SOUND ROAD
HOLY RIDGE, NC
ZIP 28445-157
Phone: (910) 329-9941
Fax: (910) 329-9943

The provider's authorized official is Marian Anne Kornegay .
The authorized official title is Vice President and has the following contact phone number (910) 275-0058.

The enumeration date for this NPI number is 2/6/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityHAL067015NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17805699MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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