Mae Corbett Connally

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL017003 Issued in NC

Legal business name

MAE CORBETT CONNALLY

Practice address

362 Hudson Rd
Milton, NC 27305-9680

Phone

(336) 234-7502

NPI assigned

Mar 29, 2007

Organization subpart

No

Name

Mrs. Mae Corbett Connelly

Title

Owner

Phone

(336) 234-7502

Tax ID family

Corbett FCH2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mae Corbett Connally

  • Adult Care Home Facility
  • Milton, NC
  • NPI 1407976889
  NPD tax ID

Locations

• Corbett FCH Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 19, 2008.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1891815593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "address_2": "SUITE 315",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735343",
            "telephone_number": "336-234-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 HUDSON RD",
            "city": "MILTON",
            "state": "NC",
            "postal_code": "273059680",
            "telephone_number": "336-234-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAE CORBETT CONNALLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "MAE",
        "authorized_official_middle_name": "CORBETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-234-7502",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL017003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802646",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corbett FCH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Enviro-Mental Behavior Group, LLC
• Gladys Poteat
• Gladys Poteat
• Julia Joubert
• Mae Corbett Connally
• New Life Horizons, LLC
• Vicky D Connally
• Vicky D Connally

• All providers in Milton, NC
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.