CHAPPELL VALLEY COTTAGE (NPI# 1417212747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417212747 |
| Entity Type | Organization |
| Organization Name | CHAPPELL VALLEY COTTAGE |
| Practice Address |
460 Beaverdam St Canton NC 28716-3350 |
| Practice Telephone | 8286483790 |
| Practice Fax Number | 8284920127 |
| Mailing Telephone | 8286483790 |
| Mailing Fax Number | 8284920127 |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-07-12 |
| Authorized Official Name | MRS. KRYSTAL HULLENDER (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 8286483790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-044-038 | NC | Nursing & Custodial Care Facilities |
| Street Address |
460 BEAVERDAM ST |
| City | CANTON |
| State | NC |
| Zip Code | 28716-3350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164689766 | Ann Davis Rest Home | Assisted Living Facility | 460 Beaverdam St, Canton, NC 28716 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699174987 | Ryan Scott Buchanan | Counselor | 118 Main St Fl 2, Canton, NC 28716 | 2014-08-22 |
| 1306991799 | William Courtenay Dinwiddie Jr. | Family Medicine | 55 Buckeye Cove Road, Canton, NC 28716 | 2007-01-24 |
| 1922175355 | Charles Richard Panther | Social Worker | 30 Pennsylvania Ave, Canton, NC 28716 | 2006-11-29 |
| 1932114881 | Ingles Markets Inc | Pharmacy | 630 Champion Dr, Canton, NC 28716-3032 | 2006-07-29 |
| 1083123608 | Ariana Debussey | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2017-09-26 |
| 1346580040 | Frank Cecil Etier Sr. | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-02-18 |
| 1346588431 | Anna Maria Apostolopoulos | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-01-23 |
| 1003171034 | Kelsie Paige Ormsby | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2012-07-05 |
| 1851568372 | Sandra Y Wyche | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2008-05-14 |
| 1548395718 | Roger D. Wells | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2007-02-21 |
| Find all providers in zip 28716 | ||||
| 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] |
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| 1871963553 | Cherokee Angel Senior Care & Training Center | Custodial Care Facility | 2442 Marietta Hwy, Suite 100, Canton, GA 30114-4023 | 2015-10-06 |
| 1295984243 | Desmond & Puller Adult Daycare Center, LLC | Custodial Care Facility | 525 E Center St, Canton, MS 39046-3909 | 2008-09-15 |
| 1225235773 | Friman Homes Incroporated | Custodial Care Facility | 42000 Koppernick Rd Ste A-7, Canton, MI 48187-4282 | 2007-06-28 |
| 1679770457 | Guerline M Francois | Custodial Care Facility | 17 Greenwood Rd, Canton, MA 02021-3907 | 2007-06-27 |
| 1528051935 | Pigeon Valley Rest Home LLC | Custodial Care Facility | 55 Lake Dr, Canton, NC 28716-9312 | 2005-08-31 |
| 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.