Elms at Tanglewood, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-034-034 Issued in NC

Legal business name

ELMS AT TANGLEWOOD, LLC

Practice address

3750 Harper Rd
Clemmons, NC 27012-8682

Phone

(336) 766-2131

Fax

(336) 766-2160

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By 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

Michelle Jones

Title

Office Manager

Phone

(336) 766-2131

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902903289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270120349",
            "telephone_number": "336-766-2131",
            "fax_number": "336-766-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 HARPER RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128682",
            "telephone_number": "336-766-2131",
            "fax_number": "336-766-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMS AT TANGLEWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "336-766-2131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-034-034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803705",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Clemmons, NC
• Providers in Clemmons, 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 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.