Maries Angels Personal Care Home,LLC

Primary specialty

Ambulatory Family Planning FacilityTaxonomy code 261QA0005X

Legal business name

MARIES ANGELS PERSONAL CARE HOME,LLC

Practice address

9 Brackenwood CT
Greensboro, NC 27407-5081

Phone

(301) 674-1622

NPI assigned

Jun 16, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Renee Yvette Goodman

Title

Co-Owner

Phone

(301) 674-1622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1023748480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BRACKENWOOD CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075081",
            "telephone_number": "301-674-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BRACKENWOOD CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075081",
            "telephone_number": "301-674-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIES ANGELS PERSONAL CARE HOME,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "301-674-1622",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julie Milstead Marine, RN
• Callie Gordon Marino, LPCA, NCC
• Michelle Marinone, M.D.
• Mark J Katz, DDS, MSD, PA

• Ambulatory Family Planning Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Ambulatory Family Planning Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.