Organization Name: | WATERSIDE HEALTHCARE INC. |
NPI Number: | 1467590042 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID B GOLDSTON (PRESIDENT) |
Mailing Address: | 520 Mulberry St Shallotte |
State: | NC US |
Postal Code: | 284704586 |
Phone Number: | 9107546621 |
Fax Number: | |
NPI Enumeration Date: | 02/03/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | HAL-010-004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |