West Bladen Assisted Living, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-009-025 Issued in NC

Legal business name

WEST BLADEN ASSISTED LIVING, LLC

Practice address

714 Bladen Street
Bladenboro, NC 28320

Phone

(910) 863-4500

Fax

(910) 863-3142

NPI assigned

Feb 10, 2011

Last updated

Feb 10, 2011By 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

Mr. Leroy Adams

Title

Member

Phone

(910) 256-5989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1265738157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 BLADEN STREET",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "28320",
            "telephone_number": "910-863-4500",
            "fax_number": "910-863-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 BLADEN STREET",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "28320",
            "telephone_number": "910-863-4500",
            "fax_number": "910-863-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BLADEN ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "910-256-5989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-009-025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jonathan Z Wang, DDS
• Pamela T Ward

• Adult Care Home Facility in Bladenboro, NC
• Providers in Bladenboro, 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 Feb 10, 2011; 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.