Mary Rebecca's Village

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-071-013 Issued in NC

Legal business name

MARY REBECCA'S VILLAGE

Practice address

13605 US Highway 17 N
Hampstead, NC 28443-1945

Phone

(910) 319-0450

NPI assigned

Apr 8, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia Danetta Garrison

Title

Administrator

Phone

(910) 527-4673

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1255774485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 SPIRALWOOD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040499",
            "telephone_number": "910-527-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13605 US HIGHWAY 17 N",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284431945",
            "telephone_number": "910-319-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY REBECCA'S VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "DANETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-527-4673",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-071-013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Ann Vavra Marki, PT
• Denise Paula Marrotta, BS PHARMACY
• Isabel Marshburn
• Karen O Marshburn, CNM
• Hailee Ann Martin, PA-C
• Diana Theresa Matthews, LMT
• Kaitlyn Ann McCormack
• Kelly Knapp McCray, LCMHCA
• Michael McDowell, LMBT
• Kelly Barton McGregor

• Adult Care Home Facility in Hampstead, NC
• Providers in Hampstead, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.