Active NPI
Metrocorp Affiliates, LTD
Doing business as Leisure Living Care Home
- Mental Illness Community Based Residential Treatment Facility
- Lumberton, NC
National Provider Identifier
1780728949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- MHL078182
- Legal business name
- METROCORP AFFILIATES, LTD
- Doing business as
- Leisure Living Care Home
- Practice address
- 83 Jerome St
Lumberton, NC 28358-6025 - Phone
- (910) 739-7592
- Fax
- (910) 738-7954
- NPI assigned
- Feb 19, 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
- Mrs. Gloria J. Ross, RN
- Title
- Executive Director
- Phone
- (704) 933-3314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MHL078182 | NC | Primary |
Addresses
Primary practice location
83 Jerome St
Lumberton, NC 28358-6025
Mailing address
950 Lane St
Kannapolis, NC 28083-3748
Phone (704) 933-3314
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7805532 | Medicaid | NC |
Other names 1
- Leisure Living Care Home
National Provider Directory
National Provider Directory- Tax ID family
- Metrocorp Affiliates LTD
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1780728949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 LANE ST",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280833748",
"telephone_number": "704-933-3314",
"fax_number": "704-933-3320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 JEROME ST",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283586025",
"telephone_number": "910-739-7592",
"fax_number": "910-738-7954"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "METROCORP AFFILIATES, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROSS",
"authorized_official_first_name": "GLORIA",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "704-933-3314",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "NC",
"license": "MHL078182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7805532",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Leisure Living Care Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lumberton, 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.