Emmanuel Family Care II,LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

FCL-001-102 Issued in NC

Legal business name

EMMANUEL FAMILY CARE II,LLC

Practice address

2655 White Oak Dr
Burlington, NC 27215-8829

Phone

(336) 585-2025

Fax

(336) 584-5037

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Marilyn Robinson Williams

Title

Administrator

Phone

(336) 585-2025

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1861511073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 WHITE OAK DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158829",
            "telephone_number": "336-585-2025",
            "fax_number": "336-584-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 WHITE OAK DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158829",
            "telephone_number": "336-585-2025",
            "fax_number": "336-584-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL FAMILY CARE II,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "ROBINSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-585-2025",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "FCL-001-102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805364",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Burlington, NC by specialty
• Custodial Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.