Home Meadows Services LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

MHL-041-1059 Issued in NC

Legal business name

HOME MEADOWS SERVICES LLC

Practice address

605 Whitsett Ave
Gibsonville, NC 27249-2042

Phone

(336) 227-1613

Fax

(336) 227-1613

NPI assigned

Aug 27, 2012

Last updated

Aug 30, 2012By 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

Mittie B Fuller

Title

Program Director/Owner

Phone

(336) 227-1613

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1265780035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1996",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272161996",
            "telephone_number": "336-227-1613",
            "fax_number": "336-227-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WHITSETT AVE",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272492042",
            "telephone_number": "336-227-1613",
            "fax_number": "336-227-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME MEADOWS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MITTIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR/OWNER",
        "authorized_official_telephone_number": "336-227-1613"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NC",
            "license": "MHL-041-1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Gibsonville, NC
• Providers in Gibsonville, NC by specialty
• Assisted Living Facility (Mental Illness) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.