TILLERY'S PLACE, LLC (NPI# 1386010908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386010908 |
| Entity Type | Organization |
| Organization Name | TILLERY'S PLACE, LLC |
| Practice Address |
200 S Tillery St Rocky Mount NC 27804-5527 |
| Practice Telephone | 2524466613 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |
| Authorized Official Name | MISS SHAVONNIE DEANS (OWNER) |
| Authorized Official Telephone | 2524466613 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-064-030 | NC | Nursing & Custodial Care Facilities |
| Street Address |
200 S TILLERY ST |
| City | ROCKY MOUNT |
| State | NC |
| Zip Code | 27804-5527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730319773 | Special Jewel Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 200 S Tillery St, Rocky Mount, NC 27804-5527 | 2009-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992288419 | Aubrey Kuester | Physical Therapist | Hunter Hills Nursing and Rehab, 7369 Hunter Hill Rd, Rocky Mount, NC 27804 | 2018-09-11 |
| 1134636475 | New Beginning Family Services of Nc | Clinic/Center | 600 Tiffany Blvd Ste H, Rocky Mount, NC 27804 | 2018-01-09 |
| 1033640776 | Simply Frazier Beauty Salon | Specialist | 1141 Jeffreys Rd, Rocky Mount, NC 27804 | 2017-03-24 |
| 1164961942 | Family Care Partners of North Carolina, Pllc | Internal Medicine | 1041 Noel Ln. Ste 105, Rocky Mt., NC 27804 | 2017-02-14 |
| 1164834867 | Ward Specialty Pharmacy LLC | Pharmacy | 3646 Sunset Ave, Suite 110 Barkley Square, Rocky Mount, NC 27804 | 2014-05-29 |
| 1891107678 | Patrick Ignacio | Pharmacist | 3646 Sunset Ave., Suite 110, Rocky Mount, NC 27804 | 2014-05-28 |
| 1023437795 | Down East Hearing | Hearing Aid Equipment | 1356 Benvenue Rd., Rocky Mount, NC 27804 | 2014-04-10 |
| 1659710416 | Sterling House of Rocky Mount | Assisted Living Facility | 650 Goldrock Road, Sterling House of Rocky Mount, Rocky Mount, NC 27804 | 2013-06-14 |
| 1700223609 | Keenya Anderson Staten | Nurse Practitioner | 1701 Sunset Ave Ste 105c, Rocky Mount, NC 27804 | 2013-05-31 |
| 1578844528 | Nathan Thomas Long | Pharmacist | 300 N Grace St Ste 150, Rocky Mount, NC 27804 | 2011-09-05 |
| Find all providers in zip 27804 | ||||
| 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 |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1891235818 | Kinillie Family Care Home | Custodial Care Facility | 448 Pleasant Hill Rd, Rocky Mount, NC 27801-8708 | 2017-02-24 |
| 1437609179 | Eugene C Davenport | Custodial Care Facility | 1327 Echo Lake Ln, Rocky Mount, NC 27803-2564 | 2016-10-06 |
| 1235688953 | Mary Robinson | Custodial Care Facility | 735 Rose St, Rocky Mount, NC 27801-5875 | 2016-09-22 |
| 1609100171 | Floyd Home Care, Inc. | Custodial Care Facility | 116 Wayne St, Rocky Mount, NC 27804-3752 | 2009-09-30 |
| 1093929754 | Knight's Family Care Homes | Custodial Care Facility | 3305 Greenfield Dr, Rocky Mount, NC 27804-8238 | 2007-05-10 |
| 1164567715 | We Care Family Care Home | Custodial Care Facility | 1101 Hill St, Rocky Mount, NC 27801-6002 | 2007-02-21 |
| 1962547505 | Your Loving Care Family Care Home | Custodial Care Facility | 730 Marigold St, Rocky Mount, NC 27801-5908 | 2007-02-21 |
| 1588702484 | Swelton Heights Haven | Custodial Care Facility | 1321 Mcdearman St, Rocky Mount, NC 27804-2640 | 2007-02-02 |
| 1083779383 | Ncal - Rocky Mount, Inc. | Custodial Care Facility | 918 Westwood Dr, Rocky Mount, NC 27803-2532 | 2006-12-27 |
| Find all providers in ROCKY MOUNT | ||||
| City | ROCKY MOUNT |
| Zip Code | 27804 |
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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.