Oliver House

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL092086 Issued in NC

Legal business name

OLIVER HOUSE

Practice address

4230 Wendell Blvd
Wendell, NC 27591-8412

Phone

(919) 366-9737

Fax

(919) 365-3394

NPI assigned

Sep 23, 2005

Last updated

Aug 22, 2020By 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

Mrs. Tina A Hallman

Title

Controller

Phone

(828) 324-8898

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265428387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1897",
            "address_2": "4230 WENDELL BOULEVARD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275911897",
            "telephone_number": "919-366-9737",
            "fax_number": "919-365-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 WENDELL BLVD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275918412",
            "telephone_number": "919-366-9737",
            "fax_number": "919-365-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVER HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALLMAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "828-324-8898",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL092086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804665",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Wendell, NC
• Providers in Wendell, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.