Daphne's Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-079-047 Issued in NC

Legal business name

DAPHNE'S FAMILY CARE HOME

Practice address

1802 Amos St
Reidsville, NC 27320-6204

Phone

(336) 342-4040

Fax

(336) 342-4999

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By 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. Daphne G Williamson

Title

Administrator

Phone

(336) 342-4040

Specialties & licenses 5

Addresses

Other identifiers 5

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780803270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273231027",
            "telephone_number": "336-342-4040",
            "fax_number": "336-342-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 AMOS ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273206204",
            "telephone_number": "336-342-4040",
            "fax_number": "336-342-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAPHNE'S FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-342-4040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-024",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-047",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-029",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-025",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-079-038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803345",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803346",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803358",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804199",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801517",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark S Cresenzo, M.D.
• Angela Crouch
• Mary D Crumpton, RD, LDN
• Curis at Reidsville Opco LLC (Curis at Reidsville Transitional Care & Rehabilitation Center)
• Karen E Daniel, CRNA
• Angelica Marcia Davis, RN
• Jacqueline Davis, RDN, LDN, IBCLC
• Jacqueline Davis
• Sydney Ashlynne Dawson, MA, LPCA
• Daymark Recovery Services Inc

• Adult Care Home Facility in Reidsville, NC
• Providers in Reidsville, NC by specialty
• Adult Care Home Facility in North Carolina

• 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.

Verify at the official NPI Registry.