Care of Diversity, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-079-101 Issued in NC

Legal business name

CARE OF DIVERSITY, LLC

Practice address

1235 Norman Dr
Apt 1B
Eden, NC 27288-5978

Phone

(336) 627-3336

NPI assigned

Jan 6, 2016

Last updated

Jan 6, 2016By 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

Senetra Reynolds

Title

Member/Administrator

Phone

(336) 627-3336

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1457717548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BOULEVARD",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 NORMAN DR",
            "address_2": "APT 1B",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885978",
            "telephone_number": "336-627-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE OF DIVERSITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "SENETRA",
        "authorized_official_title_or_position": "MEMBER/ADMINISTRATOR",
        "authorized_official_telephone_number": "336-627-3336"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Eden, NC
• Providers in Eden, 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 6, 2016; 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.