Humphrey Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-017-032 Issued in NC

Legal business name

HUMPHREY FAMILY CARE HOME

Practice address

3814 Cherry Grove Rd
Elon, NC 27244-9485

Phone

(336) 421-3001

Fax

(336) 421-3001

NPI assigned

Sep 5, 2013

Organization subpart

No

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

Authorized official

Name

Mr. David A Humphrey Sr.

Title

Director

Phone

(336) 448-0096

Specialties & licenses 1

Addresses

Tax ID family

Humphrey Family Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Humphrey Family Care Home

  • Adult Care Home Facility
  • Mebane, NC
  • NPI 1457656100
  NPD tax ID

Locations

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1275968679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 HORSESHOE TRL",
            "city": "ALTON",
            "state": "VA",
            "postal_code": "245203084",
            "telephone_number": "973-868-2690",
            "fax_number": "434-575-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 CHERRY GROVE RD",
            "city": "ELON",
            "state": "NC",
            "postal_code": "272449485",
            "telephone_number": "336-421-3001",
            "fax_number": "336-421-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMPHREY FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-448-0096",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-017-032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Elon, NC
• Providers in Elon, 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 Sep 26, 2014; 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.