Abundant Grace Family Care Home, Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ABUNDANT GRACE FAMILY CARE HOME, INC

Practice address

1140 Benson Rd Ste 201
Garner, NC 27529-4659

Phone

(862) 224-2861

NPI assigned

Nov 17, 2016

Last updated

Nov 17, 2016By 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

Obiageli N OkoliNPI 1083384804

Title

Administrator

Phone

(862) 224-2861

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Obiageli Okoli

  • Nurse Practitioner
  • Garner, NC
  • NPI 1083384804
  Authorized official Same address or phone

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1578005807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BENSON RD STE 201",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BENSON RD STE 201",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294659",
            "telephone_number": "862-224-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT GRACE FAMILY CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "OKOLI",
        "authorized_official_first_name": "OBIAGELI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "862-224-2861"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Garner, NC
• Providers in Garner, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.