Oliver Haywood Family Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OLIVER HAYWOOD FAMILY HOME LLC

Practice address

254 Grovemere LN
Wendell, NC 27591-9741

Phone

(919) 349-2473

NPI assigned

Apr 6, 2023

Last updated

Apr 6, 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

Shannon Graham

Title

President

Phone

(919) 349-2473

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1699460618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 GROVEMERE LN",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275919741",
            "telephone_number": "919-349-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 GROVEMERE LN",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275919741",
            "telephone_number": "919-349-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVER HAYWOOD FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-349-2473"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Wendell, NC
• Providers in Wendell, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.