Four Oaks Assisted Living

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL 051-026 Issued in NC

Legal business name

FOUR OAKS ASSISTED LIVING

Practice address

565 Boyette Rd.
Four Oaks, NC 27524

Phone

(910) 285-5352

NPI assigned

Apr 19, 2007

Organization subpart

No

Name

Nina C. Williams

Title

Co-Owner

Phone

(910) 285-5352

Tax ID family

Dayspring Assisted Living4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Five Star Investments, Inc

  • Adult Care Home Facility
  • Wallace, NC
  • NPI 1619193471
  NPD tax ID
• Five Star Investments, Inc.

  • Adult Care Home Facility
  • Burgaw, NC
  • NPI 1457577249
  NPD tax ID
• Five Star Investments, Inc.

  • Adult Care Home Facility
  • Wallace, NC
  • NPI 1497979025
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 19, 2008.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1326265356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275240160",
            "telephone_number": "910-285-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 BOYETTE RD.",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "27524",
            "telephone_number": "910-285-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR OAKS ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "910-285-5352"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL 051-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805537",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diversified Staffing Service
• Carl Gene Edwards Jr., PHARMD
• Quinton Edwards, PA-C
• Breanna Elizabeth Flaccavento, PA-C
• Joyce Lynn Fountain, RRT
• Four Oaks Opco Holdings, LLC
• Four Oaks Rescue Squad
• Ashley Nicole Gaussa, LPC
• Golden Age Therapy PLLC
• Betsy Denise Graham, LPN

• All providers in Four Oaks, NC
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.