Providence Place Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL041047 Issued in NC

Legal business name

PROVIDENCE PLACE ASSISTED LIVING, INC.

Practice address

630 Whittier Avenue
High Point, NC 27262-7602

Phone

(336) 888-6777

Fax

(336) 888-4663

NPI assigned

Oct 3, 2006

Last updated

Mar 16, 2015By 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

Thomas Higgins

Title

President/Ceo

Phone

(336) 888-4568

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wesleyan Arms, Inc. Former legal business name

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1538253307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 400",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "27262",
            "telephone_number": "336-888-4568",
            "fax_number": "336-888-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 WHITTIER AVENUE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627602",
            "telephone_number": "336-888-6777",
            "fax_number": "336-888-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PLACE ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "336-888-4568"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL041047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804713",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesleyan Arms, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Priority Health LLC
• Private Diagnostic Clinic, PLLC (High Point Regional Health System)
• Ricky Lee Proctor, ED.D., LAT, ATC
• Progressive Vision Optometric Group P.a.
• Sophia Proscino
• Providence Place, LLC
• Providence Place, LLC
• Bobbie Pruitt
• Pruitthealth - High Point, LLC (PruittHealth - High Point)
• Publix North Carolina, LP (Publix Pharmacy #1582)

• Assisted Living Facility in High Point, NC
• Providers in High Point, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.