PROMISES12 LTD LLC (NPI# 1093226110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093226110 |
| Entity Type | Organization |
| Organization Name | PROMISES12 LTD LLC |
| Other Organization Name | ASSESSMENTS@PROMISES12 |
| Practice Address |
35 Means Ave Se Concord NC 28025-3563 |
| Mailing Address |
3018 Rosehill Dr Charlotte NC 28212-5721 |
| Practice Telephone | 7047861500 |
| Practice Fax Number | 7047861501 |
| Mailing Telephone | 7047861500 |
| Mailing Fax Number | 7047861501 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. WILLIAM ERIC INGRAM (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7047861500 |
| Authorized Official Credential | MSW, CSAC |
| Is Organization Subpart | Y |
| Parent Organization Name | PROMISES12 LTD LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1146654 | NC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Assessments@PROMISES12 | Doing Business As Name - Organization |
| Street Address |
35 MEANS AVE SE |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-3563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992216006 | William Eric Ingram | Counselor | 35 Means Ave Se, Concord, NC 28025-3563 | 2017-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1538648944 | Morehead City Treatment Center, LLC | Clinic/Center | 403 N 35th St, Morehead City, NC 28557-3107 | 2018-08-08 |
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| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1205365574 | Western Wake Treatment Center | Clinic/Center | 2172 N. Salem Street, Suite 105, Apex, NC 27523 | 2017-06-08 |
| Find all providers with the same taxonomy | ||||
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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.