Carolina Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-032-015 Issued in NC

Legal business name

CAROLINA ASSISTED LIVING, LLC

Doing business as

Homeplace of Durham

Practice address

1002 E. Hwy 54
Durham, NC 27713

Phone

(919) 484-8518

Fax

(919) 484-8520

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Faith Cobb

Title

Executive Director

Phone

(919) 484-8518

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Homeplace of Durham Doing business as

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942372826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 E. HWY 54",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-484-8518",
            "fax_number": "919-484-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E. HWY 54",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-484-8518",
            "fax_number": "919-484-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-484-8518",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-032-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803246",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeplace of Durham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Matthew Carnino, MD
• Katherine Valencia Caro, PA-C
• Leslie Carolan, LPC
• Carolina Adolescent Center, Inc
• Carolina Alternative Services Inc.
• Carolina Behavioral Care
• Carolina Behavioral Care
• Carolina Behavioral Care
• Carolina Birth and Wellness
• Carolina Center for Autism Services, LLC (Carolina Center for ABA and Autism Treatment)

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