Provider Demographics
NPI:1992998504
Name:ALDERSGATE UNITED METHODIST RETIREMENT COMMUNITY, INC.
Entity type:Organization
Organization Name:ALDERSGATE UNITED METHODIST RETIREMENT COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELLA BROOKE
Authorized Official - Middle Name:PATTERSON
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, LNHA, ALA
Authorized Official - Phone:980-406-1540
Mailing Address - Street 1:3800 SHAMROCK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3220
Mailing Address - Country:US
Mailing Address - Phone:704-532-7000
Mailing Address - Fax:704-532-5463
Practice Address - Street 1:3211 BISHOPS WAY LANE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3220
Practice Address - Country:US
Practice Address - Phone:704-532-7000
Practice Address - Fax:704-532-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0573314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC345544Medicare Oscar/Certification