Active NPI
Gavin & Downey Heavenly Living Home II
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Norlina, NC
National Provider Identifier
1760519201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- License
- MHL-093-041
- Legal business name
- GAVIN & DOWNEY HEAVENLY LIVING HOME II
- Practice address
- 107 Harrison Rd
Norlina, NC 27563-9558 - Phone
- (252) 456-2998
- Fax
- (252) 456-2027
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Ann Lois Gavin
- Title
- Owner
- Phone
- (252) 456-9996
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | MHL-093-041 | NC | Primary |
Addresses
Primary practice location
107 Harrison Rd
Norlina, NC 27563-9558
Mailing address
119 Downey Rd
Norlina, NC 27563-9555
Phone (252) 456-9996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6603807 | Medicaid | NC |
Other names 1
- Gavin & Downey Heavenly Living Home I
National Provider Directory
National Provider Directory- Tax ID family
- Gavin Downey Heavenly Living Home 1
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Care Home Facility
- Norlina, NC
- NPI 1689994709
-
- Adult Care Home Facility
- Norlina, NC
- NPI 1114125622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1760519201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 DOWNEY RD",
"city": "NORLINA",
"state": "NC",
"postal_code": "275639555",
"telephone_number": "252-456-9996",
"fax_number": "252-456-2027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 HARRISON RD",
"city": "NORLINA",
"state": "NC",
"postal_code": "275639558",
"telephone_number": "252-456-2998",
"fax_number": "252-456-2027"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GAVIN & DOWNEY HEAVENLY LIVING HOME II",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-28",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GAVIN",
"authorized_official_first_name": "ANN",
"authorized_official_middle_name": "LOIS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "252-456-9996",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "NC",
"license": "MHL-093-041",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6603807",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gavin & Downey Heavenly Living Home I",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Norlina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.