WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL (NPI# 1114466893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114466893 |
| Entity Type | Organization |
| Organization Name | WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL |
| Other Organization Name | WALTER B JONES ALCOHOL AND DRUG ABUSE TREATMENT CENTER |
| Practice Address |
2577 W 5th St Greenville NC 27834 |
| Mailing Address |
2577 W 5th St Greenville NC 27834-7813 |
| Practice Telephone | 2527075091 |
| Practice Fax Number | 2528308585 |
| Mailing Telephone | 2527075091 |
| Mailing Fax Number | 2528308585 |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2019-05-07 |
| Authorized Official Name | MS. HELEN WOLSTENHOLME (DEPUTY SECRETARY FBBHDD SERVICES) |
| Authorized Official Telephone | 9198554700 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | NC | Residential Treatment Facilities | |
| Y | 283Q00000X | Psychiatric Hospital | NC | Hospitals |
| Other Name | Type Code |
|---|---|
| Walter B Jones Alcohol and Drug Abuse Treatment Center | Former Legal Business Name - Organization |
| Street Address |
2577 W 5TH ST |
| City | GREENVILLE |
| State | NC |
| Zip Code | 27834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861464083 | Tania Obremski | Nurse Practitioner | 2577 W 5th St, Greenville, NC 27834-7813 | 2006-02-02 |
| 1366072027 | Allyson Kate Aycock | Social Worker | 2577 W 5th St, Greenville, NC 27834-7813 | 2020-01-22 |
| 1609406826 | Rebekah Gwaltney Guyton | Counselor | 2577 W 5th St, Greenville, NC 27834-7813 | 2020-01-16 |
| 1811537202 | Leah Riddell | Counselor | 2577 W 5th St, Greenville, NC 27834-7813 | 2020-01-14 |
| 1861039190 | Walter B. Jones Woodside Treatment Center Otp | Community/Behavioral Health | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-12-05 |
| 1063069706 | Michael P Howard | Counselor | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-08-19 |
| 1922654979 | Hillary Elysse Melton | Counselor | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-08-15 |
| 1316590235 | Charles Ray Faulkner | Registered Nurse | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-07-19 |
| 1598318669 | Pamela Rogers Esposito | Social Worker | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-07-18 |
| 1356994370 | Michael Gordon Tart | Social Worker | 2577 W 5th St, Greenville, NC 27834-7813 | 2019-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
| 1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
| 1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
| 1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
| 1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
| Find all providers in zip 27834 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306139928 | Delta Regional Medical Center | Psychiatric Hospital | 300 South Washington Ave., Greenville, MS 38701 | 2011-05-17 |
| 1922078815 | Glen Oaks Hospital, Inc. | Psychiatric Hospital | 301 Division St, Greenville, TX 75401-4101 | 2006-01-24 |
| 1417496241 | The Walter B. Jones Center Woodside Treatment Center | Psychiatric Hospital | 2577 W 5th St, Greenville, NC 27834 | 2017-02-13 |
| 1891148821 | Prisma Health-upstate | Psychiatric Hospital | 701 Grove Rd, Greenville, SC 29605-4210 | 2016-07-14 |
| 1588870760 | Lakshmikantha Kumbla Md | Psychiatric Hospital | 29 L V Stabler Dr, Greenville, AL 36037-3850 | 2007-05-15 |
| 1235345893 | N D A of Alabama | Psychiatric Hospital | 29 L V Stabler Dr, Greenville, AL 36037-3850 | 2007-05-14 |
| 1457567000 | Nda of Alabama, Inc. | Psychiatric Hospital | 29 L V Stabler Dr, Greenville, AL 36037-3850 | 2007-05-14 |
| 1346300464 | Walter B Jones Alcohol and Drug Abuse Treatment Center | Psychiatric Hospital | 2577 W 5th St, Greenville, NC 27834 | 2006-12-11 |
| 1043259542 | Greenville Health System | Psychiatric Hospital | 701 Grove Rd, Greenville, SC 29605-5611 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1811406051 | Triangle Springs, LLC | Psychiatric Hospital | 10901 World Trade Blvd., Raleigh, NC 27617-4203 | 2017-09-20 |
| 1730623182 | Ralph Newman | Psychiatric Hospital | 1019 Bookmark Trl, Durham, NC 27703-9871 | 2016-12-05 |
| 1962887281 | North Carolina Agricultural and Technical State University | Psychiatric Hospital | 913 Bluford St., Greensboro, NC 27401 | 2015-07-28 |
| 1881085264 | Fayetteville Va Medical Cener | Psychiatric Hospital | 1111 Shell Dr, Apt 60, Spring Lake, NC 28390-2050 | 2015-02-06 |
| 1992044143 | Holly Hill Hospital Mobile Crisis | Psychiatric Hospital | 943 W Andrews Ave Ste K, Henderson, NC 27536-2587 | 2013-02-07 |
| 1487999652 | Unc-chapel Hill | Psychiatric Hospital | Unc Ch, 101 Manning Dr. Cb7167, Chapel Hill, NC 27599-0001 | 2012-11-29 |
| 1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
| 1639357429 | Sbh- Wilmington, LLC | Psychiatric Hospital | 2050 Mercantile Drive, Leland, NC 28451 | 2008-02-05 |
| 1295938652 | Linda Ruth Derbes | Psychiatric Hospital | 4919 S Miami Blvd, Durham, NC 27703-8435 | 2007-06-06 |
| 1992851331 | Julian F Keith Alcohol and Drug Abuse Treatment Center | Psychiatric Hospital | 201 Tabernacle Road, Black Mountain, NC 28711 | 2007-01-26 |
| Find all providers with the same taxonomy | ||||
| City | GREENVILLE |
| Zip Code | 27834 |
Please comment or provide details below to improve the information on WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL.
| 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.