NPIMap

Organization Active NPI

Angels Family Care Home #4

  • Custodial Care Facility
  • Burlington, NC
National Provider Identifier
1891813028
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
MHL-001-113 Issued in NC
Legal business name
ANGELS FAMILY CARE HOME #4
Practice address
210 Union Ave
Burlington, NC 27217-2442
Phone
(336) 570-5770
Fax
(336) 228-9376
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael J Graves
Title
Owner
Phone
(336) 222-9297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X MHL-001-113 NC Primary

Addresses

Primary practice location

210 Union Ave
Burlington, NC 27217-2442

Mailing address

210 Union Ave
Burlington, NC 27217-2442
Phone (336) 570-5770

Other identifiers 1

IdentifierTypeStateIssuer
7804934MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Angel's Family Care 24 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891813028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 UNION AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172442",
            "telephone_number": "336-570-5770",
            "fax_number": "336-228-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 UNION AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172442",
            "telephone_number": "336-570-5770",
            "fax_number": "336-228-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS FAMILY CARE HOME #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-222-9297",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "MHL-001-113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804934",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.