Provider Demographics
NPI: | 1699834812 |
---|---|
Name: | AMERICAN HEALTH LLC |
Entity type: | Organization |
Organization Name: | AMERICAN HEALTH LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | SALLIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | STROUD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 252-972-4040 |
Mailing Address - Street 1: | PO BOX 9005 |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCKY MOUNT |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27804-7005 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 252-972-4040 |
Mailing Address - Fax: | 252-972-4041 |
Practice Address - Street 1: | 173 S WINSTEAD AVE |
Practice Address - Street 2: | |
Practice Address - City: | ROCKY MOUNT |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27804-3420 |
Practice Address - Country: | US |
Practice Address - Phone: | 252-972-4040 |
Practice Address - Fax: | 252-972-4041 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-06 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | HC2524 | 163WH0200X, 311ZA0620X, 3140N1450X, 320700000X, 320800000X, 320900000X, 373H00000X, 374700000X, 3747A0650X, 3747P1801X, 376K00000X, 385HR2055X, 385HR2065X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Single Specialty |
Not Answered | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | Group - Single Specialty |
Not Answered | 3140N1450X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Nursing Care, Pediatric | Group - Single Specialty |
Not Answered | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | ||
Not Answered | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
Not Answered | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
Not Answered | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist | Group - Single Specialty | |
Not Answered | 374700000X | Nursing Service Related Providers | Technician | Group - Single Specialty | |
Not Answered | 3747A0650X | Nursing Service Related Providers | Technician | Attendant Care Provider | Group - Single Specialty |
Not Answered | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Single Specialty |
Not Answered | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Single Specialty | |
Not Answered | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | Group - Single Specialty |
Not Answered | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 3409678 | Other | CAP |
NC | 6601055 | Medicaid |