EVERGREEN ROAD FACILITY


Address: 827 Evergreen Rd, Rocky Mount, NC 27803-2426
Phone: 2524468675

EVERGREEN ROAD FACILITY (NPI# 1043409584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043409584
Entity Type Organization
Organization Name EVERGREEN ROAD FACILITY
Other Organization Name CARE FOCUS, INC.
Practice Address 827 Evergreen Rd
Rocky Mount
NC 27803-2426
Mailing Address 7227 Lee Deforest Dr
Columbia
MD 21046-3236
Practice Telephone 2524468675
Enumeration Date 2007-10-22
Last Update Date 2007-10-22
Authorized Official Name MR. DUANE BRICKHOUSE (CONTROLLER)
Authorized Official Telephone 4109101489
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 064-079 NC Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NC LICENSE 064-079 01
NC 7804569 05

Other Provider/Organization Names

Other Name Type Code
Care Focus, Inc. Other Name - Individual/Organization

Office Location

Street Address 827 EVERGREEN RD
City ROCKY MOUNT
State NC
Zip Code 27803-2426

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235367178 Monarch Community/Behavioral Health 827 Evergreen Rd, Rocky Mount, NC 27803-2426 2009-06-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043615131 Exigin Behavioral Health LLC Counselor 1105 Spring Forest Dr, Rocky Mount, NC 27803 2014-10-31
1649577180 Jeffery Beal Physical Therapist 3936 Crosswinds Drive, Rocky Mount, NC 27803 2011-02-18
1083713283 Edc Drug Stores Inc Durable Medical Equipment & Medical Supplies 824 West Raleigh Boulevard, Rocky Mount, NC 27803 2006-09-22
1013935113 Spring Arbor of Rocky Mount Assisted Living Facility 1251 S. Winstead Ave., Rocky Mount, NC 27803 2006-07-17
1053386078 William A Munn Physician Assistant 10589 East Nc 97, Rocky Mount, NC 27803 2006-02-22
1366749806 Jeffrey Miller Physical Therapist 3936 Crosswinds Drive, Rocky Mount, NC 27803 2011-02-18
1821395369 Rehab Revolution Inc. Clinic/Center 3936 Crosswinds Drive, Rocky Mount, NC 27803 2011-02-18
1053517029 Family Care Partners of North Carolina, Pllc Physician Assistant 10589 East Nc 97, Rocky Mount, NC 27803 2007-06-26
1093897340 Warren County Rescue Ambulance 123 S Grace St, Rocky Mount, NC 27803 2006-10-19
1659453900 Broad Creek Ems Ambulance 123 S Grace St, Rocky Mount, NC 27803 2006-10-19
Find all providers in zip 27803

Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316495369 Guiding Star Health Care Two, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1564 Springbrook Dr, Rocky Mount, NC 27801-3562 2016-09-20
1629488044 Williams Home Sweet Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1832 Springfield Rd, Rocky Mount, NC 27801-3060 2014-05-07
1962731463 Daniels' Family Care Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1509 Charter Dr, Rocky Mount, NC 27801-3544 2009-12-11
1700114816 Keaira's House Adult Group Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 836 Lincoln Dr, Rocky Mount, NC 27801-7456 2009-12-01
1730319773 Special Jewel Group Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 200 S Tillery St, Rocky Mount, NC 27804-5527 2009-07-24
1902047095 Rojae's Creation Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 417 N Parker St, Rocky Mount, NC 27801-5871 2009-03-18
1093987737 Edwards Enterprises Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1852 Old Wilson Rd, Rocky Mount, NC 27801-7461 2008-04-01
1376724039 Brenda W Bryan Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2001 Vernon Rd, Rocky Mount, NC 27801 2007-11-21
1063691236 Way Farer Court Facility Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 145 Wayfarer Ct, Rocky Mount, NC 27801-6282 2007-10-24
1952465999 Quality Development for Decisive People Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 736 Salisbury Dr, 736 Salisbury Dr, Rocky Mount, NC 27801-6133 2006-12-21
Find all providers in ROCKY MOUNT

Competitor

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City ROCKY MOUNT
Zip Code 27803

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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