WATERSIDE HEALTHCARE INC. NPI 1992843577

NPI Information

  • NPI: 1992843577
  • Provider Name: WATERSIDE HEALTHCARE INC.
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Doing Business As: WATERBROOKE ASSISTED LIVING
  • Address: 703 ELIZABETH ST
    TABOR CITY, NC
    ZIP 28463
  • Phone: (910) 653-6400

Map and Directions

Get Directions

NPI Details

WATERSIDE HEALTHCARE INC. is an adult care home custodial care facility in Tabor City, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. WATERSIDE HEALTHCARE INC. NPI is 1992843577. The provider is registered as an organization entity type.
The provider Is Doing Business As Waterbrooke Assisted Living.

The provider's business location address is:

703 ELIZABETH ST
TABOR CITY, NC
ZIP 28463-603
Phone: (910) 653-6400

The provider's authorized official is David B Goldston .
The authorized official title is President and has the following contact phone number (910) 754-6621.

The enumeration date for this NPI number is 2/3/2007 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
1311ZA0620XCustodial Care FacilityAdult Care HomeHAL-024-008NORTH 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
17805373MEDICAIDNORTH 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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI