Emanuel House Assisted Living, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-041-076 Issued in NC

Legal business name

EMANUEL HOUSE ASSISTED LIVING, LLC

Practice address

1030 Alamance CT
Greensboro, NC 27406-3806

Phone

(980) 275-0698

NPI assigned

Jan 3, 2012

Organization subpart

No

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

Authorized official

Name

Nikita Blakeney

Title

Owner/Administrator

Phone

(980) 275-0698

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1376813600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 INDIA HOOK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 ALAMANCE CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274063806",
            "telephone_number": "980-275-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANUEL HOUSE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "BLAKENEY",
        "authorized_official_first_name": "NIKITA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "980-275-0698"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-041-076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FCL-041-076",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Greensboro, NC
• Providers in Greensboro, 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 Mar 12, 2012; 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.