JUA VALLEY FAMILY CARE HOME #2 (NPI# 1225382070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225382070 |
| Entity Type | Organization |
| Organization Name | JUA VALLEY FAMILY CARE HOME #2 |
| Other Organization Name | JUA VALLEY FAMILY CARE HOME |
| Practice Address |
2 Jua Vly Durham NC 27707-1507 |
| Practice Telephone | 8666541113 |
| Practice Fax Number | 9194390222 |
| Mailing Telephone | 8666541113 |
| Mailing Fax Number | 9194390222 |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |
| Authorized Official Name | MRS. KANISHA DICKENS (FAMILY CARE ADMINISTRATOR) |
| Authorized Official Telephone | 8666541113 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | Y |
| Parent Organization Name | JUA VALLEY FAMILY CARE HOME |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-032-122 | NC | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| JUA VALLEY FAMILY CARE HOME | Doing Business As Name - Organization |
| Street Address |
2 JUA VLY |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| 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 |
|---|---|---|---|---|
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1922570001 | Idella Wright Homes,llc | Custodial Care Facility | 822 Midway Ave, Durham, NC 27703-5128 | 2018-12-29 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1487190401 | Pivotal Care Group Inc | Custodial Care Facility | 2905 Guess Rd, Suite 5, Durham, NC 27705-2677 | 2017-01-14 |
| 1831641604 | Pp&v Health Care Solutions LLC | Custodial Care Facility | 4901 Paces Ferry Dr, Durham, NC 27712-4103 | 2016-10-27 |
| 1578915849 | Tender Mercies II | Custodial Care Facility | 1005 Horton Rd, Durham, NC 27704-1609 | 2016-07-11 |
| 1245628197 | Cjm Holdings LLC | Custodial Care Facility | 4111 Kismet Dr, Durham, NC 27705-2838 | 2014-12-30 |
| 1639575723 | Supreme Family Care Home | Custodial Care Facility | 1120 Benning St, Durham, NC 27703-1504 | 2014-11-17 |
| 1346645868 | Autumn's Way Care Home | Custodial Care Facility | 4811 Bay Point Dr, Durham, NC 27713-9413 | 2014-10-27 |
| 1245651843 | M&l Family Care | Custodial Care Facility | 2124 Strebor Street, Durham, NC 27705-2756 | 2013-12-27 |
| Find all providers in DURHAM | ||||
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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.