Everett Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FL008010 Issued in NC

Legal business name

EVERETT FAMILY CARE HOME

Practice address

402 Broad St
Aulander, NC 27805

Phone

(252) 345-1452

Fax

(252) 345-1452

NPI assigned

Jul 11, 2007

Last updated

Jul 11, 2007By 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

Mr. Kennith Eden Greene

Title

Administrator

Phone

(252) 345-1452

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1992903926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "AULANDER",
            "state": "NC",
            "postal_code": "27805",
            "telephone_number": "252-345-1452",
            "fax_number": "252-345-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 BROAD ST",
            "city": "AULANDER",
            "state": "NC",
            "postal_code": "27805",
            "telephone_number": "252-345-1452",
            "fax_number": "252-345-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "KENNITH",
        "authorized_official_middle_name": "EDEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-345-1452",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FL008010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Aulander, NC
• Providers in Aulander, NC by specialty
• 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 11, 2007; 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.