Cherry Grove Retreat

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-017-046 Issued in NC

Legal business name

CHERRY GROVE RETREAT

Practice address

596 Neal Rd
Reidsville, NC 27320-0333

Phone

(336) 342-4395

Fax

(336) 342-2906

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Beverly Abbott Peay, LPN

Title

Administrator

Phone

(336) 342-4395

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1275700502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 NEAL RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200333",
            "telephone_number": "336-342-4395",
            "fax_number": "336-342-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 NEAL RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200333",
            "telephone_number": "336-342-4395",
            "fax_number": "336-342-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY GROVE RETREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "PEAY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ABBOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-342-4395",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-017-046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Carver, D.O.
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• Tashea R Cheeks, M.S., LPC
• Deinyell Chelley, LCAS-A
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• Joel Emery Clark
• Teyanna Cobb
• Angela Dalton Cohen
• Megan Manuel Cole, LCSW

• Adult Care Home Facility in Reidsville, NC
• Providers in Reidsville, 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 May 15, 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.