NPIMap

Organization Active NPI

Emmanuel Senior Enrichment Center

  • Adult Day Care Clinic/Center
  • High Point, NC
National Provider Identifier
1104049139
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
261QA0600X Issued in NC
Legal business name
EMMANUEL SENIOR ENRICHMENT CENTER
Practice address
1401 Heathcliff Rd
High Point, NC 27262-7451
Phone
(336) 882-6613
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Ms. E Venice Preston
Title
Executive Director
Phone
(336) 882-6613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 261QA0600X NC Primary

Addresses

Primary practice location

1401 Heathcliff Rd
High Point, NC 27262-7451

Mailing address

PO Box 5753
High Point, NC 27262-5753
Phone (336) 882-6613

Other identifiers 1

IdentifierTypeStateIssuer
3408275MedicaidNC

National Provider Directory

National Provider Directory

Locations

1401 Heathcliff Rd
High Point, NC 27262
Phone (336) 882-6613

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104049139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5753",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272625753",
            "telephone_number": "336-882-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HEATHCLIFF RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627451",
            "telephone_number": "336-882-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL SENIOR ENRICHMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "E VENICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-882-6613",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NC",
            "license": "261QA0600X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408275",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, 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.