NPIMap

Organization Active NPI

Lutheran Home Albemarle

  • Assisted Living Facility
  • Albemarle, NC
National Provider Identifier
1013104603
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
NH0140 Issued in NC
Legal business name
LUTHERAN HOME ALBEMARLE
Doing business as
Trinity Place
Practice address
24724 S Business 52
Albemarle, NC 28001-8179
Phone
(704) 982-8191
Fax
(704) 983-1118
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Mr. Eric T Gabriel Jr.
Title
Administrator
Phone
(704) 982-8191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NH0140 NC Primary

Addresses

Primary practice location

24724 S Business 52
Albemarle, NC 28001-8179

Mailing address

24724 S Business 52
Albemarle, NC 28001-8179
Phone (704) 982-8191

Other identifiers 1

IdentifierTypeStateIssuer
7801019MedicaidNC

Other names 1

  • Trinity Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Home Albemarle4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1013104603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24724 S BUSINESS 52",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018179",
            "telephone_number": "704-982-8191",
            "fax_number": "704-983-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24724 S BUSINESS 52",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018179",
            "telephone_number": "704-982-8191",
            "fax_number": "704-983-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME ALBEMARLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-982-8191",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "NH0140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801019",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.