Novella's Place, Inc.

Primary specialty

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

License

MHL-032-418 Issued in NC

Legal business name

NOVELLA'S PLACE, INC.

Practice address

2128 Old Milburnie Rd
Raleigh, NC 27604-9642

Phone

(919) 266-0146

Fax

(919) 266-0146

NPI assigned

Dec 17, 2007

Last updated

Jan 12, 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

Mr. Jesse James Banks Jr.

Title

Financial Administration

Phone

(919) 427-1402

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200096000000",
    "number": "1477737112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 E MILLBROOK RD",
            "address_2": "SUITE C-15",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095476",
            "telephone_number": "919-427-1402",
            "fax_number": "919-828-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 OLD MILBURNIE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276049642",
            "telephone_number": "919-266-0146",
            "fax_number": "919-266-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVELLA'S PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2008-01-12",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "FINANCIAL ADMINISTRATION",
        "authorized_official_telephone_number": "919-427-1402",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-032-418",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Raleigh, NC
• Providers in Raleigh, 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 Jan 12, 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.