Active NPI
Peach Tree Family Care
- Assisted Living Facility
- Raleigh, NC
National Provider Identifier
1104366863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- PEACH TREE FAMILY CARE
- Practice address
- 502 Carolina Ave
Raleigh, NC 27606-1604 - Phone
- (919) 866-9722
- Fax
- (919) 803-1951
- NPI assigned
- Feb 28, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Latonia Raynor
- Title
- Home Health Aide
- Phone
- (919) 866-9722
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
502 Carolina Ave
Raleigh, NC 27606-1604
Mailing address
5164 Simmons Branch TRL
Raleigh, NC 27606-7606
Phone (919) 866-9722
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1488240000000",
"number": "1104366863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5164 SIMMONS BRANCH TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276067606",
"telephone_number": "919-866-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 CAROLINA AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276061604",
"telephone_number": "919-866-9722",
"fax_number": "919-803-1951"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEACH TREE FAMILY CARE",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-28",
"last_updated": "2017-02-28",
"status": "A",
"authorized_official_last_name": "RAYNOR",
"authorized_official_first_name": "LATONIA",
"authorized_official_title_or_position": "HOME HEALTH AIDE",
"authorized_official_telephone_number": "919-866-9722"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.