MAE CORBETT CONNALLY NPI 1407976889

NPI Information

  • NPI: 1407976889
  • Provider Name: MAE CORBETT CONNALLY
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Doing Business As: CORBETT'S FCH-TWO
  • Address: 362 HUDSON RD
    MILTON, NC
    ZIP 27305
  • Phone: (336) 234-7502

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NPI Details

MAE CORBETT CONNALLY is an adult care home custodial care facility in Milton, NC. The provider is 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. MAE CORBETT CONNALLY NPI is 1407976889. The provider is registered as an organization entity type.
The provider Is Doing Business As Corbett's Fch-two.

The provider's business location address is:

362 HUDSON RD
MILTON, NC
ZIP 27305-680
Phone: (336) 234-7502

The provider's authorized official is Mae Corbett Connally .
The authorized official title is Woner and has the following contact phone number (336) 234-7502.

The enumeration date for this NPI number is 3/30/2007 and was last updated on 6/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeFCL017004NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17802647MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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