THE HOME PLACE (NPI# 1275027294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275027294 |
| Entity Type | Organization |
| Organization Name | THE HOME PLACE |
| Practice Address |
404 W River St Colerain NC 27924-8879 |
| Practice Telephone | 2523569954 |
| Mailing Telephone | 2523569954 |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-06-22 |
| Authorized Official Name | TONYA CLARK FREEMAN (OWNER) |
| Authorized Official Telephone | 2523569954 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL008043 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | DHHS FAMILY CARE HOME LICENSE | FCL008043 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | THE HOME PLACE COUNTRY ESTATE, LLC | 308 N. 12th Street, Fairview, OK 73737 |
| Virginia Business Entities | The Home Place Family Services LLC | 3225 Mcleod Dr Ste 100, Las Vegas, Nevada 89121 |
| Oregon Corporations, Companies and Business Names | THE HOME PLACE IN BAKER, LLC | 3078 Resort St, Baker City, OR 97814 |
| Virginia Business Entities | THE HOME PLACE OF VA. INC. | 8362 Carrollton Pike, Galax, Virginia 24333 |
| Oregon Corporations, Companies and Business Names | THE HOME PLACE RESTAURANT | 1080 North First Street, Silverton, OR 97381 |
| Virginia Business Entities | THE HOME PLACE RESTAURANT INC. | P O Box 396, Dinwiddie, Virginia 23841 |
| Street Address |
404 W RIVER ST |
| City | COLERAIN |
| State | NC |
| Zip Code | 27924-8879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568951986 | Tonya C Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-05-02 |
| 1649764762 | Tonya Clark Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861515918 | Barbara Jean Davenport | Lodging | 116 Chowan Shores Drive, Colerain, NC 27924 | 2007-04-06 |
| 1649352998 | Colerain Rescue Squad Inc | Ambulance | 110 Winton St, Colerain, NC 27924 | 2006-10-19 |
| 1174042907 | Vickie M Persaud | Day Training/Habilitation Specialist | 605 Thomas Nelson Street, Colerain, NC 27924-0134 | 2017-09-13 |
| 1619523651 | Eathelda Caldwell | Technician | 1008 Perrytown Rd, Colerain, NC 27924-8953 | 2019-08-15 |
| 1790851004 | Roanoke Chowan Community Health Center, Inc | Clinic/Center | 109 W River St, Colerain, NC 27924-9006 | 2006-11-28 |
| 1811400203 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-11-08 |
| 1720518574 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-06-14 |
| 1053680892 | Chrystie Lee Stowe | Nurse Practitioner | 109 W River St, Colerain, NC 27924-9006 | 2011-12-23 |
| 1366575268 | New Horizons Community Support Services, Inc. | Community/Behavioral Health | 126 Nc Highway 42, Colerain, NC 27924-9018 | 2007-03-13 |
| 1730374588 | New Horizons Community Support Services, Inc. | Community/Behavioral Health | 126 Nc Highway 42, Colerain, NC 27924-9018 | 2007-09-13 |
| Find all providers in zip 27924 | ||||
| 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 |
|---|---|---|---|---|
| 1568951986 | Tonya C Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-05-02 |
| 1649764762 | Tonya Clark Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
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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.