Cassandra Davis

Individual provider Active NPI Adult Care Home Facility · Louisburg, NC

NPI 1114554516 · NPPES record last updated Mar 25, 2020

Key facts

NPI
1114554516
Entity type
Individual (NPI type 1)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
FCL-035-033 (NC)
Practice address
131 Huntington Rd
Louisburg, NC 27549
Phone
(919) 729-0259
Fax
(919) 729-0259
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
FCL-035-033NCMDAdult Care Home Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Blulife Community Health LLC Current Accepting new patients
Heart to Heart Family Care Home Adult Care Home Current
since Apr 17, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X FCL-035-033 NC Yes

Addresses

Primary practice location

131 Huntington Rd
Louisburg, NC 27549

Mailing address

131 Huntington Rd
Louisburg, NC 27549
Phone (919) 729-0259

Other providers in Louisburg, NC

All providers in Louisburg, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.