Provider Demographics
NPI:1417368143
Name:ROCKY MOUNT HEALTH AND REHABILITATION, LLC
Entity type:Organization
Organization Name:ROCKY MOUNT HEALTH AND REHABILITATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SPRENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-608-9123
Mailing Address - Street 1:2221 W RALEIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-2745
Mailing Address - Country:US
Mailing Address - Phone:252-442-4156
Mailing Address - Fax:252-407-8478
Practice Address - Street 1:2221 W RALEIGH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-2745
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:2014-05-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0122314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3435137Medicaid
NC345137Medicare Oscar/Certification