Cedar Grove Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FCL040005 Issued in NC

Legal business name

CEDAR GROVE ASSISTED LIVING

Practice address

500 Free Gospel Rd
Snow Hill, NC 28580-8710

Phone

(252) 747-3504

Fax

(919) 580-9733

NPI assigned

Feb 14, 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

Mr. Christopher Lee Haveri

Title

Administrator

Phone

(919) 580-6280

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811030497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DAVELIN PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304507",
            "telephone_number": "919-580-9733",
            "fax_number": "919-580-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FREE GOSPEL RD",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285808710",
            "telephone_number": "252-747-3504",
            "fax_number": "919-580-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR GROVE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAVERI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-580-6280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL040005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Snow Hill, NC
• Providers in Snow Hill, NC by specialty
• 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.