Canaan Care Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

MHL-092-677 Issued in NC

Legal business name

CANAAN CARE HOME, LLC

Practice address

2804 Stirrup CT
Wake Forest, NC 27587-6746

Phone

(919) 556-4980

Fax

(919) 556-4980

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Daniel K. Gatabaki

Title

Administrator

Phone

(919) 556-4980

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Canaan Care Home LLC2 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.

• Canaan Care Home, LLC

  • Assisted Living Facility
  • Cary, NC
  • NPI 1285780106
  NPD tax ID

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1356475784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 STIRRUP CT",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876746",
            "telephone_number": "919-556-4980",
            "fax_number": "919-556-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 STIRRUP CT",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876746",
            "telephone_number": "919-556-4980",
            "fax_number": "919-556-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAAN CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "GATABAKI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-556-4980"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "MHL-092-677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805760",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Callison, DPT
• Hanna Calvo
• Nicole Cameron, MD
• Kimberly Campbell, LPC
• Kristen S Camplin, PNP
• Meagan Canipe, LMHCA
• Helena Marie Cannon, MA, CCC-SLP
• Delon Canterbury, DR.
• Christopher Cantey
• Capital Home Care LLC

• All providers in Wake Forest, NC
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.