Wade'S Family Care

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

FCL-001-130 Issued in NC

Legal business name

WADE'S FAMILY CARE

Practice address

918 Grace Ave
Burlington, NC 27217-4008

Phone

(336) 229-0430

Fax

(336) 229-0430

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Allen Wade

Title

Administrator

Phone

(336) 280-0512

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1427292200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 S MEBANE ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157617",
            "telephone_number": "336-280-0512",
            "fax_number": "336-280-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 GRACE AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272174008",
            "telephone_number": "336-229-0430",
            "fax_number": "336-229-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE'S FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-280-0512",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "FCL-001-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Custodial Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.