| Organization Name: | TAR RIVER LTC GROUP, LLC |
| NPI Number: | 1083659692 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NORWOOD RANDOLPH UZZELL (PRESIDENT) |
| Mailing Address: | 1341 Paradise Rd Edenton |
| State: | NC US |
| Postal Code: | 279328503 |
| Phone Number: | 2524827481 |
| Fax Number: | 2524827674 |
| NPI Enumeration Date: | 06/18/2006 |
| NPI Last Update Date: | 09/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | NH0369 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |