St.Marys Assited Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL078-052 Issued in NC

Legal business name

ST.MARYS ASSITED LIVING FACILITY

Practice address

104 Hope Lane
Red Springs, NC 28377-9999

Phone

(910) 843-5461

Fax

(910) 843-2978

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Karen Rena Bennett

Title

Administrator

Phone

(910) 843-5461

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801916796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 706",
            "city": "RED SPRINGS",
            "state": "NC",
            "postal_code": "283770706",
            "telephone_number": "910-843-5461",
            "fax_number": "910-843-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HOPE LANE",
            "city": "RED SPRINGS",
            "state": "NC",
            "postal_code": "283779999",
            "telephone_number": "910-843-5461",
            "fax_number": "910-843-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.MARYS ASSITED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "RENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-843-5461",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL078-052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805487",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Red Springs, NC
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• Assisted Living 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.