- Enrollment id
- O20051018000821
- Enrollment state
- NC
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1174608350
- Multiple npi flag
- N
- Ccn
- 345342
- Associate id
- 2961428040
- Organization name
- SENIOR VENTURES & MANAGEMENT INC
- Doing business as name
- BIG ELM RETIREMENT AND NURSING CENTER, INC
- Incorporation date
- 2005-10-01
- Incorporation state
- NC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1285 WEST A STREET
- City
- KANNAPOLIS
- State
- NC
- Zip code
- 280819501