Lucy Nannie Hairston

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-017-026 Issued in NC

Legal business name

LUCY NANNIE HAIRSTON

Practice address

3023 Chandler Mill Rd
Pelham, NC 27311-8785

Phone

(336) 939-7176

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Lucy Hairston

Title

Owner

Phone

(336) 939-7176

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• L & L Family Care Doing business as

Locations

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1972706232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 CHANDLER MILL RD",
            "city": "PELHAM",
            "state": "NC",
            "postal_code": "273118785",
            "telephone_number": "336-939-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 CHANDLER MILL RD",
            "city": "PELHAM",
            "state": "NC",
            "postal_code": "273118785",
            "telephone_number": "336-939-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCY NANNIE HAIRSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "HAIRSTON",
        "authorized_official_first_name": "LUCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-939-7176"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-017-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803034",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L & L Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Pelham, NC
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.