The Bray Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

MHL-092-469 Issued in NC

Legal business name

THE BRAY HOME

Practice address

2026 Fairview Rd
Raleigh, NC 27608-2316

Phone

(919) 946-1758

NPI assigned

Sep 17, 2012

Last updated

Sep 17, 2012By 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. Carl Diedritch Sickerott Jr.NPI 1518214022

Title

Administrator

Phone

(919) 946-1758

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carl Diedritch Sickerott Jr.

  • Adult Care Home Facility
  • Raleigh, NC
  • NPI 1518214022
  NPD (past) Authorized official

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1871843904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 FAIRVIEW RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276082316",
            "telephone_number": "919-946-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 FAIRVIEW RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276082316",
            "telephone_number": "919-946-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRAY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "SICKEROTT",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "DIEDRITCH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-946-1758",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-092-469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804353",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Aspen Center Inc.
• The Bair Foundation
• The Beauty of Dreams PLLC
• The Better Boob LLC
• The Bray Home
• The Broken Crayon Initiative
• The Bruson Group Inc. (New Beginning's Health Care Phase III)
• The Bruson Group Inc., (New Beginning's Health Care Phase II)
• The Bruson Group Inc., Dba New Beginning's Health Care
• The Bruson Group, Inc. (New Beginning's Healthcare)

• Adult Care Home Facility in Raleigh, NC
• Providers in Raleigh, 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 Sep 17, 2012; 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.