PINE ACRE FAMILY CARE HOME #1 (NPI# 1295943140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295943140 |
| Entity Type | Organization |
| Organization Name | PINE ACRE FAMILY CARE HOME #1 |
| Practice Address |
186 Pine Acres Ln Clinton NC 28328-7390 |
| Mailing Address |
186 Pine Acres Ln Clinton NC 28328-7333 |
| Practice Telephone | 9105921950 |
| Practice Fax Number | 9105928880 |
| Mailing Telephone | 9105921950 |
| Mailing Fax Number | 9105928880 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-07-03 |
| Authorized Official Name | MR. CHRISTOPHER HAROLD MITCHELL SR. (ADMINISTRATOR) |
| Authorized Official Telephone | 9105921950 |
| Authorized Official Credential | ADMNISTRATOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-082-011 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7803991 | 05 |
| Street Address |
186 PINE ACRES LN |
| City | CLINTON |
| State | NC |
| Zip Code | 28328-7390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326470741 | Ashley Brown Spell | Pharmacist | 607 Beamen St, Clinton, NC 28328 | 2013-08-08 |
| 1225315666 | Southeastern Medical Oncology Center | Internal Medicine | 211 Beaman Street, Clinton, NC 28328 | 2011-11-14 |
| 1558686386 | Keith S Kinsley | Chiropractor | 346a Northeast Blvd, Clinton, NC 28328 | 2010-04-05 |
| 1417123159 | Family First Support Center Inc | Community/Behavioral Health | 707 College St, Clinton, NC 28328 | 2008-05-02 |
| 1891985123 | The Lawsons House | Residential Treatment Facility, Emotionally Disturbed Children | 790 Corwallis Road, Teachey, NE 28328 | 2007-08-01 |
| 1053519827 | Ronald H Honeycutt | Dentist | 705 Beaman Street, Clinton, NC 28328 | 2007-07-03 |
| 1265558134 | Alternative Care Treatments Systems, Inc-clinton | Community/Behavioral Health | 207a West Main Street, Clinton, NC 28328 | 2007-03-22 |
| 1851444764 | Tara Cotton | Counselor | 302 Turlington Street, Clinton, NC 28328 | 2007-01-22 |
| 1750460952 | Sophia B Pierce & Associates Inc | Non-emergency Medical Transport (VAN) | 112 Royal Lane, Clinton, NC 28328 | 2006-11-06 |
| 1790867158 | Michelle Sessoms Simmons | Nurse Practitioner | 360 County Complex Road, (sampson County Health Department), Clinton, NC 28328 | 2006-10-19 |
| Find all providers in zip 28328 | ||||
| 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 |
|---|---|---|---|---|
| 1215315528 | Serenityhomecare | Custodial Care Facility | 1512 Clinton Raymond Rd, Clinton, MS 39056-5400 | 2015-05-07 |
| 1871777037 | Safe Haven Care, LLC | Custodial Care Facility | 9613 Plank Road, Suite O, Clinton, LA 70722 | 2007-12-24 |
| 1447452024 | Duplin Sampson Group Homes, Inc. | Custodial Care Facility | 300 Jacobs St, Clinton, NC 28328-3539 | 2007-06-05 |
| 1659580470 | Pine Acre Family Care Home #2 | Custodial Care Facility | 156 Pine Acres Ln, Clinton, NC 28328-7390 | 2007-05-21 |
| 1669551438 | Lutheran Home of Central New York | Custodial Care Facility | 108 Utica Rd, Clinton, NY 13323-1548 | 2006-11-03 |
| 1952965667 | K & J Care Enterprises, Inc. | Custodial Care Facility | 614 S Main St, Clinton, MO 64735-2620 | 2019-04-28 |
| 1104000272 | Safe Haven Care, LLC | Custodial Care Facility | 9613 Plank Road, Suite O, Clinton, LA 70722 | 2007-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 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 |
| 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.