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PRIDDY MANOR LLC NPI 1134250293


NPI Information

NPI: 1134250293
Provider Name: PRIDDY MANOR LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 34D2149669

Address:
1294 PRIDDY RD
KING, NC
ZIP 27021
Phone: (336) 983-3068
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PRIDDY MANOR LLC is an assisted living facility in King, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PRIDDY MANOR LLC NPI is 1134250293. The provider is registered as an organization entity type.

The provider's business location address is:

1294 PRIDDY RD
KING, NC
ZIP 27021-485
Phone: (336) 983-3068
Fax: (336) 983-0681

The provider's authorized official is Julie C Farmer .
The authorized official title is Owner and has the following contact phone number (336) 983-3068.

The CLIA number assigned to this NPI record is 34D2149669 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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