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General NPI Number Information
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NPI Number | 1801697453
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Entity Type | Organization
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Legal Business Name | A PLACE FOR JONITA
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 772 MAIN ST
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City | WILSON MILLS
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State | NC
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Zip | 27593
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Country | US
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Telephone | 919-901-2810
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1200
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City | FOUR OAKS
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State | NC
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Zip | 27524-1200
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Country | US
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Telephone | 919-901-2810
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MISS ANTOINETTE D WHITAKER
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Credential |
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Telephone | 919-901-2810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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