NPIMap

Organization Active NPI

John & Jennerine Enterprise, Inc.

Doing business as Life Turn

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Reidsville, NC
National Provider Identifier
1548319247
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL-079-058 Issued in NC
Legal business name
JOHN & JENNERINE ENTERPRISE, INC.
Doing business as
Life Turn
Practice address
3008 NC Highway 150
Reidsville, NC 27320-8112
Phone
(336) 342-2609
Fax
(336) 342-6362
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Mr. John Robert Wallace
Title
Owner/Eft
Phone
(336) 342-2609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-079-058 NC Primary

Addresses

Primary practice location

3008 NC Highway 150
Reidsville, NC 27320-8112

Mailing address

PO Box 1583
Reidsville, NC 27323-1583
Phone (336) 342-2609

Other names 1

  • Life Turn Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John Jennerine Enterprise Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1548319247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273231583",
            "telephone_number": "336-342-2609",
            "fax_number": "336-342-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 NC HIGHWAY 150",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208112",
            "telephone_number": "336-342-2609",
            "fax_number": "336-342-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN & JENNERINE ENTERPRISE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/EFT",
        "authorized_official_telephone_number": "336-342-2609",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-079-058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Turn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.