- Enrollment id
- O20230207003532
- Enrollment state
- NC
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1962126904
- Multiple npi flag
- N
- Ccn
- 345441
- Associate id
- 0648642215
- Organization name
- GASTONIA HEALTH & REHAB CENTER LLC
- Doing business as name
- GASTONIA HEALTH & REHAB CENTER
- Incorporation date
- 2022-09-20
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GASTONIA HEALTH & REHAB CENTER
- Affiliation entity name
- SABER HEALTHCARE GROUP
- Affiliation entity id
- 461
- Address line 1
- 1770 OAK HOLLOW RD
- City
- GASTONIA
- State
- NC
- Zip code
- 280541749