Organization Active NPI

Henderson Care Center Inc

  • Assisted Living Facility
  • Forest City, NC
National Provider Identifier
1912104423
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL-081-010 Issued in NC
Legal business name
HENDERSON CARE CENTER INC
Practice address
125 Henderson Cir
Forest City, NC 28043-2584
Phone
(828) 248-3800
Fax
(828) 245-3597
NPI assigned
Jun 28, 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. Jim Henderson
Title
Administrator
Phone
(828) 248-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL-081-010 NC Primary

Addresses

Primary practice location

125 Henderson Cir
Forest City, NC 28043-2584

Mailing address

PO Box 648
125 Henderson Circle
Forest City, NC 28043-0648
Phone (828) 248-3800

Other identifiers 1

IdentifierTypeStateIssuer
7801774MedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2020158Henderson Care Center125 Henderson Circle, Forest City, NC 28043Certificate of waiverFeb 13, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912104423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "address_2": "125 HENDERSON CIRCLE",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280430648",
            "telephone_number": "828-248-3800",
            "fax_number": "828-245-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HENDERSON CIR",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432584",
            "telephone_number": "828-248-3800",
            "fax_number": "828-245-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-248-3800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-081-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801774",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.