Kings Mountain Memory Care Center

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

KINGS MOUNTAIN MEMORY CARE CENTER

Practice address

115 Ferguson Dr
Kings Mountain, NC 28086-9727

Phone

(704) 739-5929

Fax

(704) 739-1103

NPI assigned

May 4, 2009

Organization subpart

No

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

Authorized official

Name

Patricia Odegua Adelekun, RN, MBA

Title

President

Phone

(704) 718-2327

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KINGS MOUNTAIN MEMORY CARE CENTER Other name

Locations

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1033343157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1873",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280861873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FERGUSON DR",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280869727",
            "telephone_number": "704-739-5929",
            "fax_number": "704-739-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS MOUNTAIN MEMORY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "ADELEKUN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ODEGUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-718-2327",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801288",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KINGS MOUNTAIN MEMORY CARE CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Keith Clinic Estramonte Chiropractic Kings Mountain PA
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• Margaret Kidder, CRNA
• Kings Clinic and Urgent Care PLLC
• Kings Mountain Care Center Inc.
• Kings Mountain Pediatric Clinic
• Kings Mountain Physical Therapy
• Emily Parrish Kinley
• Laurence Michael Kish, MD
• Anita Emefa Kpodo, MD

• Adult Care Home Facility in Kings Mountain, NC
• Providers in Kings Mountain, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.