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RICH SQUARE MANOR
NPI 1881762961
Assisted Living Facility in Rich Square, NC

Active since November 30, 2006CLIA 34D2019471 · Waiver
400 NORTH MAIN STREET, RICH SQUARE, NC 27869(252) 539-4145(252) 539-2479 Get Directions Write a Review

NPPES record last updated: August 10, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rich Square Manor NPPES

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

RICH SQUARE MANOR (NPI 1881762961) is a healthcare organization registered as an assisted living facility in Rich Square, North Carolina and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists James T Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1881762961
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameRV NURSING HOME, LLC
Location Address400 NORTH MAIN STREETRich Square, NC 27869-0560
Mailing Address400 North Main Street, P O Box 560Rich Square, NC 27869-0560 · (252) 539-4145 · Fax (252) 539-2479
Phone(252) 539-4145
Fax(252) 539-2479
Organization SubpartYesParent: Rv Nursing Home Llc
Authorized OfficialJames T JohnsonOwner · (252) 209-6834
Enumeration DateNovember 30, 2006
Last NPPES UpdateAugust 10, 2007
✔ NPI 1881762961 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-066-011
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.
400 NORTH MAIN STREET, Rich Square, NC 27869
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Other Names 1

Doing Business AsRich Square Manor

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 34D2019471

Rich Square Manor · Rich Square, NC
Active · expires Jan 30, 2027
CLIA Number34D2019471
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorDeanna Lanier
Laboratory Phone(252) 539-4145
Laboratory LocationRich Square Manor400 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 ASSISTED LIVING, LLC
Custodial Care Facility (Adult Care Home)
400 NORTH MAIN STREET
RICH SQUARE, NC 27869
Northampton County (252) 539-4145

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 Nursing Home, LLC's NPI number?

The NPI number for Rv Nursing Home, LLC is 1881762961. It was assigned to this organization in the NPPES registry on November 30, 2006. The provider is doing business as Rich Square Manor.

Where is Rv Nursing Home, LLC located?

Rv Nursing Home, LLC is located at 400 North Main Street, Rich Square, NC 27869. The listed phone number is (252) 539-4145.

What is Rv Nursing Home, LLC's specialty?

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

Does Rv Nursing Home, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2019471) is associated with this NPI, valid through January 30, 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 Nursing Home, LLC was last updated on August 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.