Autumn Home Care of Johnston Co., Inc. II
Organization Active NPI Assisted Living Facility · Selma, NC
NPI 1811047426 · NPPES record last updated Oct 11, 2012
Key facts
- NPI
- 1811047426
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- HAL051003 (NC)
- Legal business name
- AUTUMN HOME CARE OF JOHNSTON CO., INC. II
- Practice address
- 474 Jerry Rd
Selma, NC 27576-9248 - Phone
- (919) 965-3455
- Fax
- (919) 965-3455
- NPI assigned
- Jan 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Thomas Edward White
- Title
- President
- Phone
- (919) 965-3455
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Autumn Home Care of Johnston Co Inc I
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | HAL051003 | NC | Yes |
Addresses
Primary practice location
474 Jerry Rd
Selma, NC 27576-9248
Mailing address
474 Jerry Rd
Selma, NC 27576-9248
Phone (919) 965-3455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7806701 | Medicaid | NC |
Other providers in Selma, NC
- Julianna Hacskaglo Abernethy
- Renee Watson Adams
- Amanda Ashley Allen
- Howard Anthony
- Autumn Home Care of Johnston Co., Inc. I
- Autumn Home Care of Johnston Co., Inc. III
- Colin Patrick Barbaro
- Justin Richard Barbaro
- Thanina Belaid
- Bio-Medical Applications of North Carolina, Inc.
All providers in Selma, NC · Assisted Living Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.