Active NPI
Family Affair Care Group Management, Inc
- Intellectual Disabilities Intermediate Care Facility
- Greensboro, NC
National Provider Identifier
1295850519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- FAMILY AFFAIR CARE GROUP MANAGEMENT, INC
- Practice address
- 2302 W Meadowview Rd Ste 208
Greensboro, NC 27407-3706 - Phone
- (336) 274-1269
- Fax
- (336) 272-2387
- NPI assigned
- Mar 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Willie L Gibson
- Title
- President
- Phone
- (336) 274-1269
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | |||
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
2302 W Meadowview Rd Ste 208
Greensboro, NC 27407-3706
Mailing address
2302 W Meadowview Rd Ste 208
Greensboro, NC 27407-3706
Phone (336) 274-1269
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408898 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Family Affair Care Group Management Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Gibsonville, NC
- NPI 1942353321
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Greensboro, NC
- NPI 1770782120
Locations
2302 W Meadowview Rd
Ste 208
Greensboro, NC 27407
Phone (336) 274-1269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716940800000",
"number": "1295850519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 W MEADOWVIEW RD STE 208",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274073706",
"telephone_number": "336-274-1269",
"fax_number": "336-272-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 W MEADOWVIEW RD STE 208",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274073706",
"telephone_number": "336-274-1269",
"fax_number": "336-272-2387"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY AFFAIR CARE GROUP MANAGEMENT, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-20",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A",
"authorized_official_last_name": "GIBSON",
"authorized_official_first_name": "WILLIE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "336-274-1269",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3408898",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.