Libby J Blackwell

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LIBBY J BLACKWELL

Doing business as

Libby's Family Care Home

Practice address

4035 Woodleaf Barber Rd
Cleveland, NC 27013-9140

Phone

(704) 278-4111

Fax

(704) 278-4111

NPI assigned

Jul 26, 2023

Last updated

Oct 19, 2023By 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

Ms. Libby J Blackwell

Title

Director

Phone

(704) 278-4111

Specialties & licenses 1

Addresses

Other names 1

• Libby's Family Care Home Doing business as

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1619658341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 WOODLEAF BARBER RD",
            "city": "CLEVELAND",
            "state": "NC",
            "postal_code": "270139140",
            "telephone_number": "704-278-4111",
            "fax_number": "704-278-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 WOODLEAF BARBER RD",
            "city": "CLEVELAND",
            "state": "NC",
            "postal_code": "270139140",
            "telephone_number": "704-278-4111",
            "fax_number": "704-278-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBY J BLACKWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-278-4111",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Libby's Family Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Premise Health of North Carolina Medical PC (DTNA - Cleveland)

• Adult Care Home Facility in Cleveland, NC
• Providers in Cleveland, 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 Oct 19, 2023; 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.