Good Shepherd Family Care Home, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

MHL-041-754 Issued in NC

Legal business name

GOOD SHEPHERD FAMILY CARE HOME, LLC

Practice address

2810 Fleming Road
Greensboro, NC 27410

Phone

(336) 644-0752

Fax

(336) 643-9731

NPI assigned

Nov 6, 2007

Last updated

Dec 30, 2008By 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

Mrs. Arlene Tomas Balassu-Pascua, BSN, RN

Title

Manager

Phone

(336) 644-0752

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1841470986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3592 HANCOCK DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109157",
            "telephone_number": "336-644-0752",
            "fax_number": "336-643-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 FLEMING ROAD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27410",
            "telephone_number": "336-644-0752",
            "fax_number": "336-643-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD FAMILY CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "BALASSU-PASCUA",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "TOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "336-644-0752",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-041-754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805363",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Gonzoph, PA-C
• Good Family Services Inc
• Good Health Greensboro
• Good Life Activity Development Center
• Good Life Home Health Care LLC
• Good Times Home Health Care Inc. (Good Times Home Health Care)
• Miracle Destiny Goode
• Pandora Goode, NP C
• Makenzie Marie Goodell, RN
• Jordan Elise Gooden

• Adult Care Home Facility in Greensboro, NC
• Providers in Greensboro, 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 Dec 30, 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.