Residence Care Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RESIDENCE CARE SERVICES LLC

Doing business as

Bethamy Retreat

Practice address

102 Anne St
Spencer, NC 28159-1800

Phone

(704) 633-5212

NPI assigned

Aug 26, 2021

Last updated

Aug 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eliezer Klein, LNHA

Title

Mr

Phone

(347) 546-4877

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bethamy Retreat Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1124795232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 LAKEWOOD RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08753",
            "telephone_number": "347-546-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ANNE ST",
            "city": "SPENCER",
            "state": "NC",
            "postal_code": "281591800",
            "telephone_number": "704-633-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENCE CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "ELIEZER",
        "authorized_official_title_or_position": "MR",
        "authorized_official_telephone_number": "347-546-4877",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TomsRiver",
            "affiliation": "N",
            "address_1": "102 Anne St",
            "city": "Spencer",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281591800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bethamy Retreat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robyn Lynne Olsen-Nicotra, LCSW
• Angie D Padon, LPTA
• Elizabeth Queen, OT/R
• Donald Floyd Rankin, RPH
• Residence Care Service LLC (Bethamy Retirement Center)
• Elizabeth Denise Reynolds, DPT
• Rowan Diagnostic Clinic (Spencer Family Medicine)
• Samuel Dastrup DDS PLLC
• Holly Anne Smith, M.S., R.D., L.D.
• Sonshine Community Outreach Services

• Assisted Living Facility in Spencer, NC
• Providers in Spencer, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.