Avalon Farm

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

AVALON FARM

Practice address

166 Fair Oaks LN
Stony Point, NC 28678-9209

Phone

(704) 585-6377

NPI assigned

Aug 18, 2009

Last updated

Sep 29, 2009By 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

Miss Kimberly Ann Clarke

Title

Executive Director

Phone

(704) 585-6377

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1174755565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 FAIR OAKS LN",
            "city": "STONY POINT",
            "state": "NC",
            "postal_code": "286789209",
            "telephone_number": "704-585-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 FAIR OAKS LN",
            "city": "STONY POINT",
            "state": "NC",
            "postal_code": "286789209",
            "telephone_number": "704-585-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON FARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-585-6377",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Stony Point, NC
• Providers in Stony Point, NC by specialty
• Developmentally Disabled Services Day Training Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.