Central Long Term Care Facility Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-086-001 Issued in NC

Legal business name

CENTRAL LONG TERM CARE FACILITY INC

Practice address

139 Apex LN
Mount Airy, NC 27030-5595

Phone

(336) 320-2185

Fax

(336) 320-2186

NPI assigned

Jan 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

Bill Payne

Title

Administrator

Phone

(336) 320-2185

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972656601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 APEX LN",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305595",
            "telephone_number": "336-320-2185",
            "fax_number": "336-320-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 APEX LN",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305595",
            "telephone_number": "336-320-2185",
            "fax_number": "336-320-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL LONG TERM CARE FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-320-2185"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-086-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801411",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Casstevens, NP-C
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• Assisted Living Facility in Mount Airy, NC
• Providers in Mount Airy, 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.