Lillian Brothers Family Care Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-072-009 Issued in NC

Legal business name

LILLIAN BROTHERS FAMILY CARE HOME LLC

Practice address

533 Weight Station Rd
Hertford, NC 27944-8562

Phone

(252) 264-3185

NPI assigned

Jan 27, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Bernadine Smith, MPA

Title

Administrator

Phone

(757) 310-1430

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1417229113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 WEIGHT STATION RD",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279448562",
            "telephone_number": "252-264-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 WEIGHT STATION RD",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279448562",
            "telephone_number": "252-264-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLIAN BROTHERS FAMILY CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BERNADINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-310-1430",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL-072-009",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-072-009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Hertford, NC
• Providers in Hertford, 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 Jan 27, 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.