NPIMap

Organization Active NPI

Pearls Family Care Home # 4

  • Mental Illness Community Based Residential Treatment Facility
  • Jacksonville, NC
National Provider Identifier
1174710529
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
067014 Issued in NC
Legal business name
PEARLS FAMILY CARE HOME # 4
Practice address
102 Ash Place
Jacksonville, NC 28546
Phone
(910) 326-3526
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Authorized official

Name
Pearlie M Berry
Title
Adm
Phone
(910) 326-3526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 067014 NC Primary

Addresses

Primary practice location

102 Ash Place
Jacksonville, NC 28546

Mailing address

102 Ash Court
Jacksonville, NC 28546-9120
Phone (910) 326-3526

Other identifiers 1

IdentifierTypeStateIssuer
7804972MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pearls Family Care Home 14 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1174710529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ASH COURT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285469120",
            "telephone_number": "910-326-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ASH PLACE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "910-326-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLS FAMILY CARE HOME # 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "PEARLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADM",
        "authorized_official_telephone_number": "910-326-3526"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "067014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804972",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.