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EVERETT FAMILY CARE HOME NPI 1992903926


NPI Information

NPI: 1992903926
Provider Name: EVERETT FAMILY CARE HOME
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
402 BROAD ST
AULANDER, NC
ZIP 27805
Phone: (252) 345-1452
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EVERETT FAMILY CARE HOME is an adult care home custodial care facility in Aulander, 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. EVERETT FAMILY CARE HOME NPI is 1992903926. The provider is registered as an organization entity type.

The provider's business location address is:

402 BROAD ST
AULANDER, NC
ZIP 27805
Phone: (252) 345-1452
Fax: (252) 345-1452

The provider's authorized official is Kennith Eden Greene .
The authorized official title is Administrator and has the following contact phone number (252) 345-1452.

The enumeration date for this NPI number is 7/11/2007 and was last updated on 7/11/2007.


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 HomeFL008010NORTH 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
17803179MEDICAIDNORTH 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: 5/5/2024

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