Provider Demographics
NPI:1114739026
Name:SPRING ARBOR STEELE CREEK NC TENANT, LLC
Entity type:Organization
Organization Name:SPRING ARBOR STEELE CREEK NC TENANT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MADDRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-810-4621
Mailing Address - Street 1:420 S ORANGE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-4908
Mailing Address - Country:US
Mailing Address - Phone:407-810-2065
Mailing Address - Fax:
Practice Address - Street 1:13600 S TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7623
Practice Address - Country:US
Practice Address - Phone:646-477-8532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home