Mountain House Assisted Living of Wilkesboro, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL 097 009 Issued in NC

Legal business name

MOUNTAIN HOUSE ASSISTED LIVING OF WILKESBORO, LLC

Practice address

176 Resthome Rd
Wilkesboro, NC 28697-7145

Phone

(336) 973-3890

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Ronald B Dodson

Title

President

Phone

(336) 416-7149

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1548392327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9790",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288150790",
            "telephone_number": "336-416-7149",
            "fax_number": "336-751-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 RESTHOME RD",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977145",
            "telephone_number": "336-973-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOUSE ASSISTED LIVING OF WILKESBORO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-416-7149"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL 097 009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804712",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis Edward McNeil, NCCPSS
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• Katlynn Noland, MS, CCC-SLP

• Assisted Living Facility in Wilkesboro, NC
• Providers in Wilkesboro, 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 Apr 17, 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.