Sandy Ridge Homes Holding Corp

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

HAL-062-009 Issued in NC

Legal business name

SANDY RIDGE HOMES HOLDING CORP

Doing business as

Sandy Ridge Assisted Living

Practice address

326 Bowman Rd
Candor, NC 27229-9682

Phone

(910) 974-4162

Fax

(910) 974-6038

NPI assigned

Jan 24, 2007

Last updated

Aug 22, 2020By 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. David H Lowa, MS

Title

Administrator

Phone

(910) 974-4162

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sandy Ridge Assisted Living Doing business as

Tax ID family

Sandy Ridge Assised Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Sandy Ridge Homes Holding Corp.

  dba Sandy Ridge Assised Living

  • Assisted Living Facility
  • Candor, NC
  • NPI 1710031828
  NPD tax ID

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144375916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 BOWMAN RD",
            "city": "CANDOR",
            "state": "NC",
            "postal_code": "272299682",
            "telephone_number": "910-974-4162",
            "fax_number": "910-974-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 BOWMAN RD",
            "city": "CANDOR",
            "state": "NC",
            "postal_code": "272299682",
            "telephone_number": "910-974-4162",
            "fax_number": "910-974-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDY RIDGE HOMES HOLDING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOWA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-974-4162",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NC",
            "license": "HAL-062-009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804197",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandy Ridge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neal and Joyce Parson (Baaseiah Family Care Home III)
• New Dawn Counseling Services Inc
• Jimmy Patterson
• Rapps Group Home, Inc (Rapps Residential Services)
• Tatiana Azariah Reza
• Sandy Ridge Homes Holding Corp. (Sandy Ridge Assised Living)
• The Mental Health Association in North Carolina, Inc. (Candor Place)
• The Right Way Group Home
• Therapeutic Alternatives, Inc.
• Vision House Community Outreach Services

• Alzheimer Center (Dementia Center) in Candor, NC
• Providers in Candor, NC by specialty
• Alzheimer Center (Dementia Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.