Active NPI
Hertford Manor
- Adult Care Home Facility
- Hertford, NC
National Provider Identifier
1689390460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Legal business name
- HERTFORD MANOR
- Practice address
- 464 Two Mile Desert Rd
Hertford, NC 27944-8686 - Phone
- (252) 404-0248
- Fax
- (252) 404-0245
- NPI assigned
- Oct 13, 2022
- Organization subpart
- Yes
- Parent organization
- VIOLA VENTURES, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brittany S Nwankwo
- Title
- Ceo
- Phone
- (919) 532-9707
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Primary |
Addresses
Primary practice location
464 Two Mile Desert Rd
Hertford, NC 27944-8686
Mailing address
464 Two Mile Desert Rd
Hertford, NC 27944-8686
Phone (252) 404-0248
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | FAX | Other | Viola Ventures, LLC |
National Provider Directory
National Provider Directory- Tax ID family
- Hertford Manor
- Part of
- Hertford Manor
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Raleigh, NC
- NPI 1023739158
Locations
464 Two Mile Desert Rd
Hertford, NC 27944
Phone (252) 402-5317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665619200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665619200000",
"number": "1689390460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "464 TWO MILE DESERT RD",
"city": "HERTFORD",
"state": "NC",
"postal_code": "279448686",
"telephone_number": "252-404-0248",
"fax_number": "252-404-0245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464 TWO MILE DESERT RD",
"city": "HERTFORD",
"state": "NC",
"postal_code": "279448686",
"telephone_number": "252-404-0248",
"fax_number": "252-404-0245"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HERTFORD MANOR",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VIOLA VENTURES, LLC",
"enumeration_date": "2022-10-13",
"last_updated": "2022-10-13",
"certification_date": "2022-10-07",
"status": "A",
"authorized_official_last_name": "NWANKWO",
"authorized_official_first_name": "BRITTANY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "919-532-9707"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "FAX",
"affiliation": "Y",
"endpointDescription": "FAX",
"affiliationName": "Viola Ventures, LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FAX",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FAX",
"address_1": "464 Two Mile Desert Rd",
"city": "Hertford",
"state": "NC",
"country_code": "US",
"postal_code": "279448686",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hertford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.