FAIR HAVEN OF FOREST CITY LLC (NPI# 1770995094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770995094 |
Entity Type | Organization |
Organization Name | FAIR HAVEN OF FOREST CITY LLC |
Other Organization Name | FAIR HAVEN OF FOREST CITY LLC |
Practice Address |
830 Bethany Church Rd Forest City NC 28043-8106 |
Mailing Address |
149 Fairhaven Dr Bostic NC 28018-8759 |
Practice Telephone | 8282452852 |
Practice Fax Number | 8282482590 |
Mailing Telephone | 8282459095 |
Mailing Fax Number | 8282457856 |
Enumeration Date | 2014-05-21 |
Last Update Date | 2016-01-14 |
Authorized Official Name | MR. JOHN J CILONE (CFO) |
Authorized Official Telephone | 8282459095 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 310400000X | Assisted Living Facility | NH0474 | NC | Nursing & Custodial Care Facilities |
Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
FAIR HAVEN OF FOREST CITY LLC | Doing Business As Name - Organization |
Street Address |
830 BETHANY CHURCH RD |
City | FOREST CITY |
State | NC |
Zip Code | 28043-8106 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174509731 | Ssc Forest City Operating Company, LLC | Skilled Nursing Facility | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2005-12-15 |
1588223317 | Michaela Gamez | Speech-Language Pathologist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2019-06-06 |
1649745811 | Robert Eugene Underwood Jr. | Occupational Therapist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2018-10-03 |
1245743368 | Kapri Pierce | Speech-Language Pathologist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2017-11-10 |
1477095586 | Natalie Sloboda | Speech-Language Pathologist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2016-11-07 |
1326495110 | Hannah Summerlin | Speech-Language Pathologist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2016-05-20 |
1841663978 | Wesley Summerlin | Speech-Language Pathologist | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2015-11-11 |
1972766137 | Autumn Corporation | Custodial Care Facility | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2008-07-08 |
1164693420 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2008-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528475530 | Lori Hammond West | Pharmacist | 139 East Main St, Forest City, NC 28043 | 2014-07-22 |
1982989943 | Hope Care Center, Inc. | Assisted Living Facility | 136 Yelton's Circle, Forest City, NC 28043 | 2011-10-20 |
1770804643 | Brandi R Holtsclaw | Physical Therapist | 2270 Us Hwy 74a Suite 341, Onesource Rehab, Forest City, NC 28043 | 2010-06-15 |
1093944217 | New Start of The Piedmont Inc. | Community/Behavioral Health | 331 South. Broadway Street., Forest City, NC 28043 | 2009-07-09 |
1568690493 | Directcare Community Based Services, LLC | Community/Behavioral Health | 129 First Street, Forest City, NC 28043 | 2009-06-30 |
1760663058 | Americare Developmental Services | Residential Treatment Facility, Emotionally Disturbed Children | 313 Harrill Rd, Forest City, NC 28043 | 2007-11-15 |
1255529038 | Respiratory At Home Plus, Corp. | Durable Medical Equipment & Medical Supplies | 338 Withrow Road, Suite D, Forest City, NC 28043 | 2007-10-05 |
1821129362 | K D Support Services / Kelly's Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 158 Us Highway 221a, Forest City, NC 28043 | 2007-03-08 |
1407986714 | Americas Living Centers LLC | Custodial Care Facility | 128 Country Meadows Lane, Forest City, NC 28043 | 2007-03-06 |
1821157256 | Hopewell Care Inc. | Assisted Living Facility | 141 Fox Run, Forest City, NC 28043 | 2006-12-08 |
Find all providers in zip 28043 |
Taxonomy Code | 314000000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Skilled Nursing Facility |
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174509731 | Ssc Forest City Operating Company, LLC | Skilled Nursing Facility | 830 Bethany Church Rd, Forest City, NC 28043-8106 | 2005-12-15 |
1750378196 | Ltc Associates | Skilled Nursing Facility | 915 Delaware St, Forest City, PA 18421-1005 | 2005-09-30 |
1548729619 | Forest City Care Continuum LLC | Skilled Nursing Facility | 915 Delaware St, Forest City, PA 18421-1005 | 2019-03-18 |
1063936565 | Forest City Center for Nursing and Rehabilitation LLC | Skilled Nursing Facility | 915 Delaware St, Forest City, PA 18421-1005 | 2017-07-27 |
1700163334 | Fcnrc, Lp | Skilled Nursing Facility | 915 Delaware St, Forest City, PA 18421-1005 | 2011-11-10 |
1770745598 | Ltc Associates LLC | Skilled Nursing Facility | 915 Delaware St, Forest City, PA 18421-1005 | 2008-07-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164063756 | Cary Senior Housing I Opco, LLC | Skilled Nursing Facility | 221 Brightmore Dr, Cary, NC 27518-8145 | 2019-10-04 |
1629535455 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 621 Chestnut Ridge Pkwy, Blowing Rock, NC 28605-8962 | 2019-02-28 |
1871063214 | Vero Health X, LLC | Skilled Nursing Facility | 417 Cloverdale Rd, Sylva, NC 28779-0679 | 2018-11-28 |
1821573809 | Carolina Bay Healthcare Center of Wilmington, LLC | Skilled Nursing Facility | 740 Diamond Shoals Rd, Wilmington, NC 28403-4388 | 2018-09-26 |
1093228397 | Bellarose Nursing and Rehab Center, Inc. | Skilled Nursing Facility | 200 Bellarose Lake Way, Garner, NC 27529-7049 | 2017-11-08 |
1558872333 | Brunswick Health & Rehab Center, LLC | Skilled Nursing Facility | 9600 No 5 School Rd Nw, Ash, NC 28420-2122 | 2017-10-19 |
1538684212 | Eagle Acquisition Vi LLC | Skilled Nursing Facility | 901 S Halstead Blvd., Elizabeth City, NC 27909-6920 | 2017-08-03 |
1982130811 | Ashton Health and Rehabilitation, LLC | Skilled Nursing Facility | 5533 Burlington Rd, Mc Leansville, NC 27301-9622 | 2017-05-11 |
1831625037 | Supplemental Healthcare | Skilled Nursing Facility | 319 Vancouver Drive, Apartment 38g, Fayetteville, NC 28303 | 2017-05-08 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
Find all providers with the same taxonomy |
City | FOREST CITY |
Zip Code | 28043 |
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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.