Healthcare Provider Details

I. General information

NPI: 1174783971
Provider Name (Legal Business Name): BAILEY'S RESPITE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2008
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 CEDAR RUN PL NW
WILSON NC
27896-1308
US

IV. Provider business mailing address

2305 CEDAR RUN PL NW
WILSON NC
27896-1308
US

V. Phone/Fax

Practice location:
  • Phone: 252-234-0350
  • Fax: 522-234-0351
Mailing address:
  • Phone: 252-234-0350
  • Fax: 522-234-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. APRIL BAILEY BUTCHER
Title or Position: RN/DIRECTOR
Credential: RN
Phone: 252-236-5124