LEAKSVILLE REST HOME #2
NPI 1689796278
Assisted Living Facility in Eden, NC

Active since April 04, 2007
914 IRVING AVE, EDEN, NC 27288(336) 623-5700(336) 623-5708 Get Directions Write a Review

NPPES record last updated: June 17, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Assisted Living Facility

About LEAKSVILLE REST HOME #2

This page provides the complete NPI Profile along with additional information for Leaksville Rest Home #2, a provider established in Eden, North Carolina operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1689796278 assigned on April 2007. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Stephanie Arthur Pulliam (Administrator)

NPI
1689796278 Verify this NPI
Provider Name
LEAKSVILLE REST HOME #2
Entity Type
Organization
Location Address
914 IRVING AVE EDEN, NC 27288
Location Phone
(336) 623-5700
Location Fax
(336) 623-5708
Mailing Address
914 IRVING AVE EDEN, NC 27288
Mailing Phone
(336) 623-5700
Mailing Fax
(336) 623-5708
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-04-2007
Last Update Date
06-17-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

STEPHANIE ARTHUR PULLIAM

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(336) 623-5700

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689796278, enumerated as an "organization" on April 04, 2007.

The provider is located at 914 IRVING AVE EDEN, NC 27288 and the phone number is (336) 623-5700.

Assisted Living Facility with taxonomy code 310400000X.