Enoch Group Home

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

MHL-001-207 Issued in NC

Legal business name

ENOCH GROUP HOME

Practice address

433 N Logan St
Burlington, NC 27217-2339

Phone

(336) 506-6641

Fax

(336) 226-7405

NPI assigned

Jan 19, 2011

Last updated

Jan 19, 2011By 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. Garnetta Enoch Moore

Title

Director

Phone

(336) 506-6641

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1477858678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3062",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272150062",
            "telephone_number": "336-506-6641",
            "fax_number": "336-226-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N LOGAN ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172339",
            "telephone_number": "336-506-6641",
            "fax_number": "336-226-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENOCH GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GARNETTA",
        "authorized_official_middle_name": "ENOCH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-506-6641",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NC",
            "license": "MHL-001-207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Burlington, NC
• Providers in Burlington, NC by specialty
• Assisted Living Facility (Mental Illness) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.