Leaksville Rest Home #2

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LEAKSVILLE REST HOME #2

Practice address

914 Irving Ave
Eden, NC 27288-5510

Phone

(336) 623-5700

Fax

(336) 623-5708

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Stephanie Arthur Pulliam

Title

Administrator

Phone

(336) 623-5700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1689796278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 IRVING AVE",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885510",
            "telephone_number": "336-623-5700",
            "fax_number": "336-623-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 IRVING AVE",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885510",
            "telephone_number": "336-623-5700",
            "fax_number": "336-623-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAKSVILLE REST HOME #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-623-5700"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Layne'S Family Pharmacy, Inc
• Layne'S Family Pharmacy, Inc.
• Layne'S Family Pharmacy, Inc.
• Laynecare LLC
• Laynes Family Pharmacy
• Leaksville Rest Home, LLC
• Okafor Mang Lekwuwa, MD
• John Lesueur, D.C.
• Felicia Lewis
• Jacqueline Lenore Lewis, RN

• Assisted Living Facility in Eden, NC
• Providers in Eden, 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 Jun 17, 2008; 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.