- Enrollment id
- O20190403001546
- Enrollment state
- NC
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1437627593
- Multiple npi flag
- N
- Ccn
- 345304
- Associate id
- 8628319589
- Organization name
- ACCORDIUS HEALTH AT MIDWOOD LLC
- Incorporation date
- 2018-06-07
- Incorporation state
- NC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2727 SHAMROCK DR
- City
- CHARLOTTE
- State
- NC
- Zip code
- 282052215