Ec Southern Pines Operations, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-063-020 Issued in NC

Legal business name

EC SOUTHERN PINES OPERATIONS, LLC

Practice address

101 Brucewood Rd
Southern Pines, NC 28387-5159

Phone

(910) 692-4928

Fax

(910) 692-0899

NPI assigned

Feb 22, 2008

Organization subpart

No

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

Authorized official

Name

Mr. W. Patrick Mulloy II

Title

President

Phone

(502) 753-6001

Specialties & licenses 1

Addresses

Other names 1

• Elmcroft of Southern Pines Other name

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1801065933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 ORMSBY STATION RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234081",
            "telephone_number": "502-753-6000",
            "fax_number": "502-753-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRUCEWOOD RD",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875159",
            "telephone_number": "910-692-4928",
            "fax_number": "910-692-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EC SOUTHERN PINES OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "MULLOY",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-753-6001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-063-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmcroft of Southern Pines",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Melton Stonewall Ellerbe, LCAS

• Adult Care Home Facility in Southern Pines, NC
• Providers in Southern Pines, 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 Feb 22, 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.