St Marys Home Care Agency

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

0000 Issued in NC

Legal business name

ST MARYS HOME CARE AGENCY

Practice address

3401 Village Dr
Fayetteville, NC 28304-4551

Phone

(910) 433-4477

Fax

(910) 920-3179

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Rashae N Williams, BS

Title

Ceo

Phone

(910) 433-4477

Specialties & licenses 3

Addresses

Other identifiers 5

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1285711879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044551",
            "telephone_number": "910-433-4477",
            "fax_number": "910-920-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044551",
            "telephone_number": "910-433-4477",
            "fax_number": "910-920-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOME CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RASHAE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-433-4477",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "0000",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC2557",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601100",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301378",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302206",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700445",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408108",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilshawnda Squires
• Priyanka Srinivas
• Heather Marie Sroka, BSW, MSW, LCSW-A
• SRRC Psychology
• St Marys HCA of South Carolina
• Ricci St. Jules, M.S., D.O
• Annie Stackhouse
• Savannah Lavinia Stackhouse
• Tymera Dreyona Idasia Stafford
• Felicia Stakely

• Case Management Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.