Community Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-001-162 Issued in NC

Legal business name

COMMUNITY CARE HOME

Practice address

1104 S Church St
Burlington, NC 27215-5048

Phone

(336) 350-8295

NPI assigned

Dec 4, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Hazel J Spruill

Title

Owener

Phone

(336) 350-2690

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1124493945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 S CHURCH ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155048",
            "telephone_number": "336-350-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 S CHURCH ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155048",
            "telephone_number": "336-350-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "SPRUILL",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWENER",
        "authorized_official_telephone_number": "336-350-2690",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-001-162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Burlington, NC
• Providers in Burlington, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.