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RICH SQUARE VILLA
NPI 1316184922
Custodial Care Facility - Adult Care Home in Rich Square, NC

Active since January 20, 2009CLIA 34D2019473 · Waiver
310 NORTH MAIN STREET, RICH SQUARE, NC 27869(252) 539-2011(252) 539-2317 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Rich Square Villa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICH SQUARE VILLA (NPI 1316184922) is a healthcare organization registered as an adult care home in Rich Square, North Carolina and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through July 10, 2027 and lists Charles E Trefzger, Manager, as its authorized official.

NPPES Registry Identity

NPI1316184922
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameRV ASSISTED LIVING, LLC
Location Address310 NORTH MAIN STREETRich Square, NC 27869-9568
Mailing AddressPo Box 2568Hickory, NC 28603-2568 · (828) 322-5535 · Fax (828) 326-8115
Phone(252) 539-2011
Fax(252) 539-2317
Organization SubpartNo
Authorized OfficialCharles E TrefzgerManager · (828) 322-5535
Enumeration DateJanuary 20, 2009
Last NPPES UpdateOctober 11, 2021
NPPES CertifiedOctober 11, 2021
✔ NPI 1316184922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
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.
Also ListedAssisted Living FacilityTaxonomy 310400000X · License HAL-066-010 (NC)
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
310 NORTH MAIN STREET, Rich Square, NC 27869
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Other Names 1

Doing Business AsRich Square Villa

Other Identifiers 1

Medicaid7805824NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2019473

Rich Square Villa · Rich Square, NC
Active · expires Jul 10, 2027
CLIA Number34D2019473
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 11, 2025
Certificate Expiration DateJuly 10, 2027
Laboratory DirectorDeanna Lanier
Laboratory Phone(252) 539-2011
Laboratory LocationRich Square Villa310 North Main Street, Rich Square, NC 27869
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RV NURSING HOME, LLC
Assisted Living Facility
310 NORTH MAIN STREET
RICH SQUARE, NC 27869
Northampton County (252) 539-2011

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rv Assisted Living, LLC's NPI number?

The NPI number for Rv Assisted Living, LLC is 1316184922. It was assigned to this organization in the NPPES registry on January 20, 2009. The provider is doing business as Rich Square Villa.

Where is Rv Assisted Living, LLC located?

Rv Assisted Living, LLC is located at 310 North Main Street, Rich Square, NC 27869. The listed phone number is (252) 539-2011.

What is Rv Assisted Living, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Rv Assisted Living, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2019473) is associated with this NPI, valid through July 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rv Assisted Living, LLC was last updated on October 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.