Reidsville Holdings LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL079055 Issued in NC

Legal business name

REIDSVILLE HOLDINGS LLC

Doing business as

Reidsville House

Practice address

305 S Branch St
Reidsville, NC 27320-3917

Phone

(336) 349-5595

Fax

(336) 634-0931

NPI assigned

Feb 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Hodges

Title

Member Manager

Phone

(828) 738-3046

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reidsville House Doing business as

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063548295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S BRANCH ST",
            "address_2": "PO BOX 300",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203917",
            "telephone_number": "336-349-5595",
            "fax_number": "336-634-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S BRANCH ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203917",
            "telephone_number": "336-349-5595",
            "fax_number": "336-634-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIDSVILLE HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "828-738-3046"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL079055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805587",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reidsville House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Reidsville, NC
• Providers in Reidsville, NC by specialty
• Assisted Living Facility in North Carolina

• 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.