Yanceyville Operating Al, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

YANCEYVILLE OPERATING AL, LLC

Doing business as

Caswell House

Practice address

535 US Highway 158 W
Yanceyville, NC 27379-8305

Phone

(336) 694-1555

NPI assigned

Dec 3, 2009

Organization subpart

No

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

Authorized official

Name

Charles E Trefzger Jr.

Title

Authorized Official

Phone

(828) 261-7312

Specialties & licenses 1

Addresses

Other names 1

• Caswell House Doing business as

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1932437894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-322-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798305",
            "telephone_number": "336-694-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANCEYVILLE OPERATING AL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "828-261-7312",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caswell House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Fielding Willis, M.D.
• Miranda G Worley, PA-C
• WP-Yanceyville Health Holdings, LLC (Caswell House)
• Paul David Wyman, FNP-C
• Yanceyville Opco LLC
• Yanceyville Primary Care PA
• Youth Haven Services, Inc.
• Serena Shunan Zhou-Talbert, M.D., MPH

• Assisted Living Facility in Yanceyville, NC
• Providers in Yanceyville, 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 Dec 3, 2009; 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.