NPIMap

Organization Active NPI

Eaglemere Living Facility

  • Developmental Disabilities Clinic/Center
  • Rocky Mount, NC
National Provider Identifier
1235388133
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
MHL064087 Issued in NC
Legal business name
EAGLEMERE LIVING FACILITY
Practice address
200 Eagles Mere TRL
Rocky Mount, NC 27804-8850
Phone
(252) 446-2571
NPI assigned
Sep 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Mr. George A Brown Jr.
Title
Co-Owner
Phone
(252) 446-2571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X MHL064087 NC Primary

Addresses

Primary practice location

200 Eagles Mere TRL
Rocky Mount, NC 27804-8850

Mailing address

200 Eagles Mere TRL
Rocky Mount, NC 27804-8850
Phone (252) 446-2571

National Provider Directory

National Provider Directory
Tax ID family
Eagle Mere Living Facilityadult Care Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1235388133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAGLES MERE TRL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048850",
            "telephone_number": "252-446-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAGLES MERE TRL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048850",
            "telephone_number": "252-446-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEMERE LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "252-446-2571",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NC",
            "license": "MHL064087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.