# EMANUEL HOUSE ASSISTED LIVING, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376813600
- **Authorized official:** NIKITA BLAKENEY (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (980) 275-0698

## Contact information

- **Practice address:** 1030 ALAMANCE CT, GREENSBORO, NC 27406-3806
- **Practice address phone:** (980) 275-0698
- **Mailing address:** 2008 INDIA HOOK RD, ROCK HILL, SC 29732-1220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-041-076 | NC | Yes |

## Other

- **Enumeration date:** 01/03/2012
- **Last updated:** 03/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | FCL-041-076 | — | NC |