Carillon Assisted Living of Harrisburg

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

License

HAL-013-017 Issued in NC

Legal business name

CARILLON ASSISTED LIVING OF HARRISBURG

Practice address

6200 Roberta Rd
Harrisburg, NC 28075-8418

Phone

(704) 455-6226

NPI assigned

May 18, 2007

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

Mrs. Evie G. Maderios

Title

Accounts Receivable Manager

Phone

(919) 852-4000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962610782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 WATERS EDGE DR",
            "address_2": "STE. 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062464",
            "telephone_number": "919-852-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 ROBERTA RD",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280758418",
            "telephone_number": "704-455-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARILLON ASSISTED LIVING OF HARRISBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MADERIOS",
        "authorized_official_first_name": "EVIE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "919-852-4000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lodging",
            "state": "NC",
            "license": "HAL-013-017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803442",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Nichol Briscoe, MA LCMHCS NCC CTMH
• Fredericka Brooks, FNP
• Linda Brown, LCSWA
• Taylor Marie Brown
• Cabarrus Memorial Hospital (Northeast Psychiatric &Psychological Institute)
• Glenda Carlton, PHARMD
• Carolina Eye Doctors OD PLLC
• Carolina Physical Therapy Associates LLC (CORA Physical Therapy - Harrisburg)
• Carolinas Medical Center-Northeast (NorthEast Psychiatric Services - Harrisburg)
• Carolinas Medical Center-Northeast (Ardsley Internal Medicine-Harrisburg)

• Lodging Provider in Harrisburg, NC
• Providers in Harrisburg, NC by specialty
• Lodging Provider 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.