Needham Family Care Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FLC15001 Issued in NC

Legal business name

NEEDHAM FAMILY CARE HOME INC

Practice address

916 Sandy Hook Rd
Shiloh, NC 27974

Phone

(252) 336-4344

Fax

(252) 336-4342

NPI assigned

Apr 12, 2007

Last updated

Aug 10, 2007By 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. Rodney Marvin Needham Sr.

Title

President Administrator Owner

Phone

(252) 336-4344

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1861616872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 SANDY HOOK RD",
            "city": "SHILOH",
            "state": "NC",
            "postal_code": "27974",
            "telephone_number": "252-336-4344",
            "fax_number": "252-336-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 SANDY HOOK RD",
            "city": "SHILOH",
            "state": "NC",
            "postal_code": "27974",
            "telephone_number": "252-336-4344",
            "fax_number": "252-336-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEEDHAM FAMILY CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "NEEDHAM",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "MARVIN",
        "authorized_official_title_or_position": "PRESIDENT ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "252-336-4344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FLC15001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801023",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiera Elise Clark, NP
• Life, Inc. (Wickham Road Facility)

• Assisted Living Facility in Shiloh, NC
• Providers in Shiloh, 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 10, 2007; 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.