NL & Jr Incorporated

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

CRC0762 Issued in SC

Legal business name

NL & JR INCORPORATED

Doing business as

Goose Creek Manor

Practice address

104 Marilyn St
Goose Creek, SC 29445-3104

Phone

(843) 572-7442

NPI assigned

Jul 1, 2013

Organization subpart

No

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

Authorized official

Name

Leticia Dedios

Title

Administrator

Phone

(843) 572-7442

Specialties & licenses 2

Addresses

Other names 1

• Goose Creek Manor Doing business as

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1881034247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MARILYN ST",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MARILYN ST",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453104",
            "telephone_number": "843-572-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NL & JR INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "DEDIOS",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-572-7442"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC0762",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC0639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goose Creek Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anhthu Nguyen
• Trinh Tina Hue Nguyen
• NHC Charleston
• NHC Charleston
• Jacqueline Nicole Nicola, PHARMD
• Caleb S Nobles, PT, DPT
• Jeffrey Thomas Noelcke, PT, DPT
• Carolyn Denise Ogrodnik
• Ohio Valley Physicians Inc
• Jamilette Ojeda, M.A., CCC-SLP

• Assisted Living Facility in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Assisted Living Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.