Forest Trail of Clinton, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL082014 Issued in NC

Legal business name

FOREST TRAIL OF CLINTON, LLC

Doing business as

The Magnolia

Practice address

213 Forest TRL
Clinton, NC 28328-3353

Phone

(910) 592-7506

Fax

(910) 592-7604

NPI assigned

Sep 23, 2005

Last updated

Dec 15, 2008By 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

Mrs. Tina A Hallman

Title

Controller

Phone

(828) 322-5535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Magnolia Doing business as

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1699761718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 FOREST TRL",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283353",
            "telephone_number": "910-592-7506",
            "fax_number": "910-592-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 FOREST TRL",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283353",
            "telephone_number": "910-592-7506",
            "fax_number": "910-592-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST TRAIL OF CLINTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "HALLMAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "828-322-5535",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL082014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805300",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Magnolia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family Medical Supply LLC
• Joshua Ferrell, M.D.
• Susie Fitzgerald, DO
• Andres R Fleury-Guzman, MD
• FLR Counseling LLC
• Fuller & Associates VII PLLC
• Rashida Asha Fuller, LCSW-A
• Derrick Cornelius Fullwood
• Michael A Galletti, D.O.
• Gateway to Better Help, LLC

• Assisted Living Facility in Clinton, NC
• Providers in Clinton, 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 Dec 15, 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.