MT. OLIVE FAMILY CARE HOME #2 NPI 1700914595

NPI Information

NPI: 1700914595
Provider Name: MT. OLIVE FAMILY CARE HOME #2
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
14471 NC HIGHWAY 41 S
FAIRMONT, NC
ZIP 28340
Phone: (910) 628-7594
Get Directions

MT. OLIVE FAMILY CARE HOME #2 is an adult care home custodial care facility in Fairmont, NC. The provider is 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. MT. OLIVE FAMILY CARE HOME #2 NPI is 1700914595. The provider is registered as an organization entity type.

The provider's business location address is:

14471 NC HIGHWAY 41 S
FAIRMONT, NC
ZIP 28340-977
Phone: (910) 628-7594

The provider's authorized official is Willie Edward Spruill .
The authorized official title is Administrator and has the following contact phone number (910) 628-7755.

The enumeration date for this NPI number is 3/1/2007 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
1	311ZA0620X	Custodial Care Facility	Adult Care Home	FCL-078-015	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7801471	MEDICAID	NORTH CAROLINA

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »