Grantham Family Care Home 2

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

FCL096009 Issued in NC

Legal business name

GRANTHAM FAMILY CARE HOME 2

Practice address

107 N Georgia Ave
Goldsboro, NC 27530-3531

Phone

(919) 735-2121

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Charles L Grantham

Title

Owner

Phone

(919) 735-2121

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1235314774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S JOHN ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303531",
            "telephone_number": "919-735-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N GEORGIA AVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303531",
            "telephone_number": "919-735-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTHAM FAMILY CARE HOME 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-735-2121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "FCL096009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802189",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Graham, NP
• Joan Grant-Chin, PHARM D
• Sally L Grant, LCAS
• Terry Alan Grant, M.D.
• Grantham Family Care Home 1
• Grantham Family Home Inc
• Darian L Grantham
• Lauren Michelle Grantham, LPCA
• Michael Anthony Graulich, LMBT
• Sandra Gray-Raiford

• Health Service Clinic/Center in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Health Service Clinic/Center in North Carolina

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