Clemmons Village I

LBN: Cemmons Village I, Llc
Clemmons Village I is an health care organization with primary practice located at 6401 Holder Rd , Clemmons NC 27012-9207. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Cemmons Village I, Llc can be contacted via phone (336) 766-2990, or through Hadley, Eric via phone (843) 296-3985.

Contact Information

Primary practice address
6401 Holder Rd Clemmons NC 27012-9207
Phone: (336) 766-2990
Fax: (336) 766-2138
Website:
Map and Directions
Authorized official contact:
Name: Hadley, Eric
Phone: (843) 296-3985

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X HAL-034-090 North Carolina

Profile Details

NPI number 1013008234
LBN Legal business name Cemmons Village I, Llc
DBA Doing business as Clemmons Village I
Authorized official Hadley, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Sep 27th, 2006
Last updated Jun 21st, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013008234 NPPES
North Carolina MEDICAID 7805214

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