NPIMap

Organization Active NPI

Eaglemerelivingfacility

  • Adult Mental Health Clinic/Center
  • Rocky Mount, NC
National Provider Identifier
1639485667
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
EAGLEMERELIVINGFACILITY
Doing business as
na
Practice address
200 Eagles Mere TRL
Rocky Mount, NC 27804-8850
Phone
(252) 442-4209
NPI assigned
Aug 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Authorized official

Name
Mr. George Brown Jr., NA
Title
Co-Owner
Phone
(252) 907-4805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

200 Eagles Mere TRL
Rocky Mount, NC 27804-8850

Mailing address

200 Eagles Mere TRL
Rocky Mount, NC 27804-8850
Phone (252) 442-4209

Other names 1

  • na Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eagle Mere Living Facilityadult Care Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1639485667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAGLES MERE TRL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048850",
            "telephone_number": "252-442-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAGLES MERE TRL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048850",
            "telephone_number": "252-442-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEMERELIVINGFACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "252-907-4805",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "NA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "na",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.