MARY REBECCA'S VILLAGE (NPI# 1255774485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255774485 |
| Entity Type | Organization |
| Organization Name | MARY REBECCA'S VILLAGE |
| Practice Address |
13605 Us Highway 17 N Hampstead NC 28443-1945 |
| Mailing Address |
1887 Spiralwood Dr Fayetteville NC 28304-0499 |
| Practice Telephone | 9103190450 |
| Mailing Telephone | 9105274673 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-04-09 |
| Authorized Official Name | MS. CYNTHIA DANETTA GARRISON (ADMINISTRATOR) |
| Authorized Official Telephone | 9105274673 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-071-013 | NC | Nursing & Custodial Care Facilities |
| Street Address |
13605 US HIGHWAY 17 N |
| City | HAMPSTEAD |
| State | NC |
| Zip Code | 28443-1945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284745 | Jenean Lacorte | Specialist/Technologist, Other | 18676 Hwy 17 N., Suite 11, Hampstead, NC 28443 | 2020-10-29 |
| 1457966947 | Lauren Paige Nester | Registered Nurse | 113 Pagoda Ct., Hampstead, NC 28443 | 2020-09-10 |
| 1326503657 | Village Pharmacy of Hampstead Inc | Pharmacy | 14057 Hwy 17, Suite 100, Hampstead, NC 28443 | 2019-01-31 |
| 1154896280 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 1397 Us Hwy 17 North, Hampstead, NC 28443 | 2018-10-04 |
| 1134580178 | William Boone | Specialist/Technologist | 106 Katydid Ct, Hampstead, NC 28443 | 2016-03-18 |
| 1679959837 | New River Wellness, Pa | Social Worker | 15444 Us Highway 17 North, Bldg 233, Hampstead, NC 28443 | 2015-08-10 |
| 1932509791 | Laura Behr Jarosz | Physician Assistant | 114 Osier Dr, Hampstead, NC 28443 | 2014-08-29 |
| 1053737064 | Katelyn Braswell | Student in an Organized Health Care Education/Training Program | 309 Knollwood Dr, Hampstead, NC 28443 | 2014-03-14 |
| 1598101826 | Johnson Drug Hampstead Inc. | Pharmacy | 17230 Us Hwy 17n, Suite 222, Hampstead, NC 28443 | 2013-05-14 |
| 1053658302 | James William Boyer | Specialist/Technologist, Other | 1768 Hwy 210, Hampstead, NC 28443 | 2013-01-07 |
| Find all providers in zip 28443 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1154896280 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 1397 Us Hwy 17 North, Hampstead, NC 28443 | 2018-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| 1598302960 | Ga Hc Reit II Lincolnton Alf Trs Sub, LLC | Custodial Care Facility | 440 Salem Church Rd, Lincolnton, NC 28092-8856 | 2019-12-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.