Organization Active NPI

Koru Services LLC

  • Assisted Living Facility (Mental Illness)
  • Williamston, NC
National Provider Identifier
1629600770
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
KORU SERVICES LLC
Practice address
412 Warren St
Williamston, NC 27892-2454
Phone
(252) 215-7679
NPI assigned
Feb 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Tenisha C Bazemore
Title
Ceo
Phone
(252) 215-7679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

412 Warren St
Williamston, NC 27892-2454

Mailing address

412 Warren St
Williamston, NC 27892-2454
Phone (252) 215-7679

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1629600770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 WARREN ST",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922454",
            "telephone_number": "252-215-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 WARREN ST",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922454",
            "telephone_number": "252-215-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORU SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2025-09-11",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "BAZEMORE",
        "authorized_official_first_name": "TENISHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-215-7679"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.