Pine Acre Family Care Home #1

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-082-011 Issued in NC

Legal business name

PINE ACRE FAMILY CARE HOME #1

Practice address

186 Pine Acres LN
Clinton, NC 28328-7390

Phone

(910) 592-1950

Fax

(910) 592-8880

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Harold Mitchell Sr., ADMNISTRATOR

Title

Administrator

Phone

(910) 592-1950

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pine Acre Family Care Home 12 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.

• Pine Acre Family Care Home #2

  • Adult Care Home Facility
  • Clinton, NC
  • NPI 1659580470
  NPD tax ID

Locations

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1295943140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 PINE ACRES LN",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283287333",
            "telephone_number": "910-592-1950",
            "fax_number": "910-592-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 PINE ACRES LN",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283287390",
            "telephone_number": "910-592-1950",
            "fax_number": "910-592-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE ACRE FAMILY CARE HOME #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-592-1950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "ADMNISTRATOR"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-082-011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803991",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peterkin and Associates, Inc.
• Pharming Company
• Pharming Company
• Pharming Company
• Lauren Sink Phillips, DDS
• Pine Acre Family Care Home #2
• Pinnacle Family Services of North Carolina LLC
• Carolyn Riner Pope, FNP
• Erica Pope
• Chasity Poplin

• Adult Care Home Facility in Clinton, NC
• Providers in Clinton, 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 Jul 3, 2008; 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.