Provider Demographics
NPI:1194952028
Name:UNIVERSAL PROPERTIES/ RM, LLC
Entity type:Organization
Organization Name:UNIVERSAL PROPERTIES/ RM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:A/R DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:SUTTON
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-464-1817
Mailing Address - Street 1:2221 RALEIGH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-3729
Mailing Address - Country:US
Mailing Address - Phone:252-442-4156
Mailing Address - Fax:252-407-8478
Practice Address - Street 1:2221 RALEIGH RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-3729
Practice Address - Country:US
Practice Address - Phone:252-442-4156
Practice Address - Fax:252-407-8478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3425137Medicaid
NC7803186Medicaid
NC345137Medicare Oscar/Certification