Provider Demographics
NPI:1942551395
Name:NANAS FAMILY CARE HOMES
Entity type:Organization
Organization Name:NANAS FAMILY CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:RIPPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-391-6925
Mailing Address - Street 1:133 BANKROFT CT
Mailing Address - Street 2:RAEFORD
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-7628
Mailing Address - Country:US
Mailing Address - Phone:910-391-6925
Mailing Address - Fax:
Practice Address - Street 1:847 ZAPATA LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-8456
Practice Address - Country:US
Practice Address - Phone:910-391-6925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA00001467163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty