Kiononia Haven Homes, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

KIONONIA HAVEN HOMES, LLC

Practice address

507 Tobacco Rd
Rocky Mount, NC 27801-6936

Phone

(252) 266-5496

NPI assigned

Sep 19, 2012

Organization subpart

No

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

Authorized official

Name

Pamela L Foreman

Title

Director

Phone

(252) 266-5496

Specialties & licenses 4

Addresses

Other names 1

• Kiononia Group Home Services, LLC Doing business as

Locations

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1396095147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 JEFFREYS ROAD",
            "address_2": "PMB 273",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "27804",
            "telephone_number": "252-266-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 TOBACCO RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278016936",
            "telephone_number": "252-266-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIONONIA HAVEN HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-266-5496"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "0000000000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kiononia Group Home Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Troy Kimpton, MD
• Briana Lorraine King, LCSWA
• Marona King
• Kinillie Family Care Home
• Paul M Kinnaird, MD
• Brianne C Klinger, PMHNP-BC, FNP-BC
• KLW Home for U, LLC
• Emily Maye Knight, PA-C
• Knight'S Family Care Homes
• Kim Eng Koo, M.D.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

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