CLEMMONS VILLAGE II
NPI 1649355439
Assisted Living Facility in Clemmons, NC

Q: What is Clemmons Assisted Living LLC's NPI number?

The NPI number for Clemmons Assisted Living LLC is 1649355439. It was assigned to this organization in the NPPES registry on October 27, 2006. The provider is doing business as Clemmons Village II.

Q: What is Clemmons Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 27, 2006CLIA 34D2027875 · Waiver

6441 HOLDER RD, CLEMMONS, NC 27012(336) 778-8548(336) 778-8875 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Clemmons Village Ii NPPES

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

CLEMMONS VILLAGE II (NPI 1649355439) is a healthcare organization registered as an assisted living facility in Clemmons, North Carolina and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 2, 2027 and lists Aldo Baccala, Owner / Manager, as its authorized official.

NPPES Registry Identity

NPI1649355439

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameCLEMMONS ASSISTED LIVING LLC

Location Address6441 HOLDER RDClemmons, NC 27012-9207

Mailing Address6441 Holder RdClemmons, NC 27012-9207 · (336) 778-8548 · Fax (336) 778-8875

Phone(336) 778-8548

Fax(336) 778-8875

Organization SubpartNo

Authorized OfficialAldo BaccalaOwner / Manager · (707) 778-6713

Enumeration DateOctober 27, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1649355439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in NC · HAL-034-062

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

6441 HOLDER RD, Clemmons, NC 27012

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Other Names 1

Doing Business AsClemmons Village Ii

Other Identifiers 1

Medicaid7804691NC

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 34D2027875

Clemmons Village II · Clemmons, NC

Active · expires Aug 2, 2027

CLIA Number34D2027875

Laboratory TypeAssisted Living Facility

Certificate Effective DateAugust 3, 2025

Certificate Expiration DateAugust 2, 2027

Laboratory DirectorCindy Rehmeyer

Laboratory Phone(336) 778-8548

Laboratory LocationClemmons Village II6441 Holder Road, Clemmons, NC 27012

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Clemmons Assisted Living LLC's NPI number?

The NPI number for Clemmons Assisted Living LLC is 1649355439. It was assigned to this organization in the NPPES registry on October 27, 2006. The provider is doing business as Clemmons Village II.

Where is Clemmons Assisted Living LLC located?

Clemmons Assisted Living LLC is located at 6441 Holder Rd, Clemmons, NC 27012. The listed phone number is (336) 778-8548.

What is Clemmons Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Clemmons Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2027875) is associated with this NPI, valid through August 2, 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 Clemmons Assisted Living LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.