Universal Group Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

MHL-096-255 Issued in NC

Legal business name

UNIVERSAL GROUP HOME LLC

Practice address

609 E Main St
Mount Olive, NC 28365-2248

Phone

(919) 344-8846

NPI assigned

Aug 20, 2014

Organization subpart

No

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

Authorized official

Name

Sandra Faye SpruillNPI 1952717043

Title

Director

Phone

(919) 344-8846

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Spruill

  • Adult Care Home Facility
  • Goldsboro, NC
  • NPI 1952717043
  NPD (past) Authorized official

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1285033761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FOREST DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275343323",
            "telephone_number": "919-344-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E MAIN ST",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283652248",
            "telephone_number": "919-344-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "SPRUILL",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-344-8846"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-096-255",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-031-075",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-096-254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Renee Truzy, BA
• TSH-Mt Olive PCS
• Tracy Tucker
• Shearldena M. Turner
• Riley Houston Tyndall, DPT
• Visavis Health Care Medical Group of NC PLLC
• Richard Wagoner
• Wal-Mart Stores East LP
• Walgreen Co
• Christine Walker

• Adult Care Home Facility in Mount Olive, NC
• Providers in Mount Olive, 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 Aug 20, 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.