Provider Demographics
NPI:1720145113
Name:ALEXANDRIA ADELAIDE, INC.
Entity type:Organization
Organization Name:ALEXANDRIA ADELAIDE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-342-4946
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27323-0026
Mailing Address - Country:US
Mailing Address - Phone:336-342-4946
Mailing Address - Fax:336-342-4799
Practice Address - Street 1:312 BROAD ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-6506
Practice Address - Country:US
Practice Address - Phone:336-342-4946
Practice Address - Fax:336-342-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-079-004310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility