CLASSIC CARE HOLDINGS LLC (NPI# 1295219715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295219715 |
| Entity Type | Organization |
| Organization Name | CLASSIC CARE HOLDINGS LLC |
| Other Organization Name | CLASSIC CARE HOLDINGS 103 |
| Practice Address |
103 Annie Parker Cir Smithfield NC 27577-3970 |
| Practice Telephone | 9199348976 |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2018-09-24 |
| Authorized Official Name | MR. VISHRUT PATEL (COO) |
| Authorized Official Telephone | 9199348976 |
| Is Organization Subpart | Y |
| Parent Organization Name | CLASSIC CARE HOLDINGS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| N | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities | ||
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| CLASSIC CARE HOLDINGS 103 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578047098 | Classic Care Holdings LLC | Assisted Living Facility | 105 Annie Parker Cir, Smithfield, NC 27577-3968 | 2018-09-20 |
| 1093299745 | Classic Care Holdings LLC | Assisted Living Facility | 101 Annie Parker Cir, Smithfield, NC 27577-3976 | 2018-09-19 |
| Street Address |
103 ANNIE PARKER CIR |
| City | SMITHFIELD |
| State | NC |
| Zip Code | 27577-3970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659418846 | Classic Care Homes 103 | Assisted Living Facility | 103 Annie Parker Cir, Smithfield, NC 27577-3970 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919047 | Sherwin Cuaresma Bernardino | Physical Therapist | Meadowview Assisted Living Center, 250 Nc-210, Smithfield, NC 27577 | 2020-07-14 |
| 1386297299 | Johnston Opco, LLC | Non-emergency Medical Transport (VAN) | 200 Kellie Dr, Smithfield, NC 27577 | 2019-07-19 |
| 1790255362 | Adrian Brook Taylor | Physical Therapist | 540 North Street, Smithfield, NC 27577 | 2018-11-27 |
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1720593908 | Latorya Delois Moore | Nurse Practitioner | 514 N Brightleaf Blvd Ste 1100, Smithfield, NC 27577 | 2017-12-09 |
| 1124546171 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 104 N Brightleaf Blvd, Smithfield, NC 27577 | 2017-08-30 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1407203318 | Linda Pearl Trujillo | Early Intervention Provider Agency | 623 Tralee Dr, Smithfield, NC 27577 | 2016-05-20 |
| 1336500206 | Saundra Casey | Counselor | 15 Noble Street, Smithfield, NC 27577 | 2016-03-18 |
| 1639537707 | Ralph Edwin Wilson Jr. | Physician Assistant | 100 Kellie Drive, Smithfield, NC 27577 | 2016-02-04 |
| Find all providers in zip 27577 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1083972194 | Meadowview Al Operations, LLC | Assisted Living Facility | 250 Nc 210 Hwy, Smithfield, NC 27577-6970 | 2012-04-26 |
| 1285831354 | Autumn Wind of Smithfield, Inc. | Assisted Living Facility | 4302 Nc Highway 210, Smithfield, NC 27577-7915 | 2007-06-30 |
| 1508906595 | Meadowview Housing, Inc. | Assisted Living Facility | 250 Highway 210 West, Smithfield, NC 27577-6970 | 2007-02-07 |
| 1437298783 | Classic Care Homes 105 | Assisted Living Facility | 105 Annie Parker Cir, Smithfield, NC 27577-3968 | 2007-02-05 |
| 1659418846 | Classic Care Homes 103 | Assisted Living Facility | 103 Annie Parker Cir, Smithfield, NC 27577-3970 | 2007-01-30 |
| 1417002445 | Classic Care Homes | Assisted Living Facility | 101 Annie Parker Cir, Smithfield, NC 27577-3968 | 2007-01-23 |
| 1538225412 | Southern Assisted Living, LLC. | Assisted Living Facility | 830 Berkshire Rd, Smithfield, NC 27577-4729 | 2006-12-28 |
| 1124127998 | Senior Lifestyle North Bay Limited Partnership | Assisted Living Facility | 171 Pleasant View Ave, Smithfield, RI 02917 | 2006-09-21 |
| 1285109157 | 171 Pleasant View Operations, LLC | Assisted Living Facility | 171 Pleasant View Ave, Smithfield, RI 02917-1792 | 2018-10-08 |
| Find all providers in SMITHFIELD | ||||
| City | SMITHFIELD |
| Zip Code | 27577 |
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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.