NPIMap

Organization Active NPI

Home Away From Home

  • Assisted Living Facility
  • Gibsonville, NC
National Provider Identifier
1013048107
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
FCL 079-051 Issued in NC
Legal business name
HOME AWAY FROM HOME
Practice address
334 Zeb Rd
Gibsonville, NC 27249-9507
Phone
(336) 342-2213
Fax
(336) 349-7985
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Shuvon Levette Rankin, RN
Title
Owner, Administrator
Phone
(336) 348-9924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X FCL 079-051 NC Primary

Addresses

Primary practice location

334 Zeb Rd
Gibsonville, NC 27249-9507

Mailing address

PO Box 155
Reidsville, NC 27323-0155
Phone (336) 342-2213

Other names 1

  • Blackwell Rankin Inc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Blackwell Rankin Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013048107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273230155",
            "telephone_number": "336-342-2213",
            "fax_number": "336-349-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 ZEB RD",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272499507",
            "telephone_number": "336-342-2213",
            "fax_number": "336-349-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME AWAY FROM HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "SHUVON",
        "authorized_official_middle_name": "LEVETTE",
        "authorized_official_title_or_position": "OWNER, ADMINISTRATOR",
        "authorized_official_telephone_number": "336-348-9924",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL 079-051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackwell Rankin Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gibsonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.