Piedmont Village at Yadkinville, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-099-008 Issued in NC

Legal business name

PIEDMONT VILLAGE AT YADKINVILLE, INC.

Doing business as

Piedmont Village at Yadkinville

Practice address

305 Harrison Ave
Yadkinville, NC 27055-8247

Phone

(336) 679-2386

Fax

(336) 679-4510

NPI assigned

Jul 21, 2006

Last updated

Aug 22, 2020By 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

Mr. Paul Walczak

Title

Ceo

Phone

(561) 627-0664

Specialties & licenses 1

Addresses

Other names 1

• Piedmont Village at Yadkinville Doing business as

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598785305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102911",
            "telephone_number": "561-627-0664",
            "fax_number": "561-627-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HARRISON AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558247",
            "telephone_number": "336-679-2386",
            "fax_number": "336-679-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT VILLAGE AT YADKINVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALCZAK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-627-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-099-008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Village at Yadkinville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Partnership for a Drug Free NC, Inc.
• Partnership for a Drug Free NC, Inc.
• Partnership for a Drug Free NC, Inc.
• Angela Creel Peyton
• Piedmont Gastroenterology Specialists
• Pinebrook Residential Center 1
• Pinebrook Residential Center 2
• Wendy June Pirk, LPN
• Carl J Porchey, MD
• Luz-Hazel Maria Pyle

• Assisted Living Facility in Yadkinville, NC
• Providers in Yadkinville, 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 Aug 22, 2020; 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.