Mae Corbett Connally

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL017004 Issued in NC

Legal business name

MAE CORBETT CONNALLY

Doing business as

Corbett's FCH-Two

Practice address

362 Hudson Rd
Milton, NC 27305-9680

Phone

(336) 234-7502

NPI assigned

Mar 30, 2007

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mae Corbett Connally

Title

Woner

Phone

(336) 234-7502

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Corbett's FCH-Two Doing business as

Tax ID family

Corbett FCH2 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.

• Mae Corbett Connally

  dba Corbett FCH

  • Adult Care Home Facility
  • Milton, NC
  • NPI 1891815593
  NPD tax ID

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1407976889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "address_2": "SUITE 315",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735343",
            "telephone_number": "336-234-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 HUDSON RD",
            "city": "MILTON",
            "state": "NC",
            "postal_code": "273059680",
            "telephone_number": "336-234-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAE CORBETT CONNALLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CONNALLY",
        "authorized_official_first_name": "MAE",
        "authorized_official_middle_name": "CORBETT",
        "authorized_official_title_or_position": "WONER",
        "authorized_official_telephone_number": "336-234-7502",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL017004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802647",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corbett's FCH-Two",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Julia Joubert
• Mae Corbett Connally (Corbett FCH)
• New Life Horizons, LLC
• Vicky D Connally (Corbetts Family Care Home 2)
• Vicky D Connally (Corbetts Family Care)

• Adult Care Home Facility in Milton, NC
• Providers in Milton, 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 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.