| Organization Name: | CRANBERRY HOUSE, LLC |
| NPI Number: | 1417157975 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES E TREFZGER (MANANGER) |
| Mailing Address: | 6215 Us 19e Elk Park |
| State: | NC US |
| Postal Code: | 28622 |
| Phone Number: | 8287335558 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2007 |
| NPI Last Update Date: | 10/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311500000X |
| License Number: | HAL-006-004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Alzheimer Center (Dementia Center) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer |