THE MANDALAY GROUP 1 (NPI# 1073883328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073883328 |
| Entity Type | Organization |
| Organization Name | THE MANDALAY GROUP 1 |
| Practice Address |
2429 Blueberry Ridge Rd Matthews NC 28105-4167 |
| Practice Telephone | 7048499132 |
| Practice Fax Number | 7043219164 |
| Mailing Telephone | 7048499132 |
| Mailing Fax Number | 7043219164 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | MS. JOYCE MARIAN FLETCHER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7048499132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
2429 BLUEBERRY RIDGE RD |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578178588 | Emmanuel Homecare, Inc. | Community/Behavioral Health | 12551 Hashanli Pl, Matthews, NC 28105-3401 | 2020-09-15 |
| 1164048120 | Qc House of Hope | Community/Behavioral Health | 9915 Treeside Ln, Matthews, NC 28105-7221 | 2020-06-24 |
| 1033755038 | Monarch | Community/Behavioral Health | 202 Raintree Dr, Matthews, NC 28104-7315 | 2019-11-25 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1952831158 | Serenity Counseling Services | Community/Behavioral Health | 5232 Margaret Wallace Rd, Matthews, NC 28105-2110 | 2017-06-20 |
| 1174067417 | The Lifeskills Counseling & Consulting Group | Community/Behavioral Health | 1300 Matthews Mint Hill Rd, Matthews, NC 28105-2306 | 2016-12-06 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1417301045 | Transitional Life, LLC | Community/Behavioral Health | 4202 Painted Trillium Ct, Matthews, NC 28105-0120 | 2016-04-20 |
| 1861874794 | 321 Mental Health/substance Abuse Crisis Response Center, Pllc | Community/Behavioral Health | 3232 Summerfield Ridge Ln, Matthews, NC 28105-8507 | 2015-06-27 |
| 1538595632 | Transcend E.d. | Community/Behavioral Health | 134 W Matthews St, Matthews, NC 28105-1305 | 2013-09-20 |
| Find all providers in MATTHEWS | ||||
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| 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.