Gahc3 Clemmons NC TRS Sub, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

GAHC3 CLEMMONS NC TRS SUB, LLC

Doing business as

Cadence at Clemmons

Practice address

1165 S Peace Haven Rd
Clemmons, NC 27012-8910

Phone

(336) 766-6220

Fax

(336) 766-7613

NPI assigned

Sep 26, 2019

Last updated

Oct 28, 2019By 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

Danny Prosky

Title

President

Phone

(949) 270-9200

Specialties & licenses 2

Addresses

Other names 1

• Cadence at Clemmons Doing business as

Locations

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1285285601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18191 VON KARMAN AVE STE 300",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926127106",
            "telephone_number": "949-270-9200",
            "fax_number": "949-474-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 S PEACE HAVEN RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128910",
            "telephone_number": "336-766-6220",
            "fax_number": "336-766-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHC3 CLEMMONS NC TRS SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "PROSKY",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-270-9200"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cadence at Clemmons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cadence at Clemmons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Winifred Ellen Fox, PHD LMFT, LPC
• Parker Freeman, RBT
• Mary Grace Freier
• James W Freshwater Jr., O.D.
• Molly Lynn Fuller, M.D., PH.D.
• Mary Juliana Garner, MSW, LCSW
• Gaston Family Health Services, Inc (Kintegra/SHA at West Forsyth High)
• Gastroenterology Associates of the Piedmont, P.a.
• Kelsey George
• Suzanne Michelle Gerald, FNP-C

• Custodial Care Facility in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Custodial Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.