Provider Demographics
NPI:1801697453
Name:A PLACE FOR JONITA
Entity type:Organization
Organization Name:A PLACE FOR JONITA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-901-2810
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-1200
Mailing Address - Country:US
Mailing Address - Phone:919-901-2810
Mailing Address - Fax:
Practice Address - Street 1:772 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILSON MILLS
Practice Address - State:NC
Practice Address - Zip Code:27593
Practice Address - Country:US
Practice Address - Phone:919-901-2810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No347C00000XTransportation ServicesPrivate Vehicle