Community Care Center of Haywood #1

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL044004 Issued in NC

Legal business name

COMMUNITY CARE CENTER OF HAYWOOD #1

Practice address

39 Loving Way
Clyde, NC 28721-9471

Phone

(828) 452-0238

Fax

(828) 452-5473

NPI assigned

Mar 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Faye Owen

Title

Administrator

Phone

(828) 452-0238

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790804516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 LOVING WAY",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219471",
            "telephone_number": "828-452-0238",
            "fax_number": "828-452-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 LOVING WAY",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219471",
            "telephone_number": "828-452-0238",
            "fax_number": "828-452-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CENTER OF HAYWOOD #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "FAYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-452-0238",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL044004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802622",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clyde Emergency Solutions LLC
• Kerry P Cogburn, D.D.S. P.A.
• Ellen Colasuonno, MS, RDN, LDN
• Filiberto Colon II, MD
• Kimberly Lynn Comeau, LPC
• Kenneth Richard Cook, MSW, LCSW
• Tina Sparks Cook, R.N.
• County of Haywood
• County of Haywood
• County of Haywood

• Adult Care Home Facility in Clyde, NC
• Providers in Clyde, 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.