NPIMap

Organization Active NPI

Riverside Village Homes Inc

  • Assisted Living Facility
  • Leicester, NC
National Provider Identifier
1114712445
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
RIVERSIDE VILLAGE HOMES INC
Practice address
236 Country Time LN
Leicester, NC 28748-6213
Phone
(910) 417-7351
NPI assigned
Apr 9, 2025
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Jessica ClarkeNPI 1699137141
Title
Owner
Phone
(910) 417-7351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

236 Country Time LN
Leicester, NC 28748-6213

Mailing address

PO Box 55
Fletcher, NC 28732-0055

National Provider Directory

National Provider Directory
Tax ID family
Riverside Village Homes Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

236 Country Time Ln
Leicester, NC 28748

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1114712445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287320055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 COUNTRY TIME LN",
            "city": "LEICESTER",
            "state": "NC",
            "postal_code": "287486213",
            "telephone_number": "910-417-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE VILLAGE HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-417-7351"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leicester, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.