MY FRIEND'S HOUSE, LLC (NPI# 1164662466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164662466 |
Entity Type | Organization |
Organization Name | MY FRIEND'S HOUSE, LLC |
Practice Address |
3607 Columbia Avenue Wilson NC 27896 |
Practice Telephone | 2522067408 |
Practice Fax Number | 3123240677 |
Mailing Telephone | 2522067408 |
Mailing Fax Number | 3123240677 |
Enumeration Date | 2009-02-26 |
Last Update Date | 2009-02-26 |
Authorized Official Name | MS. CONNIE BUTTERFIELD (OWNER/MEMBER) |
Authorized Official Telephone | 2522067408 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
3607 COLUMBIA AVENUE |
City | WILSON |
State | NC |
Zip Code | 27896 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528543972 | Realo Discount Drug Stores of Eastern North Carolina, Inc | Durable Medical Equipment & Medical Supplies | 3724 Raleigh Road Parkway, Suite A, Wilson, NC 27896 | 2018-10-02 |
1518450865 | Alysann Brooke Price | Social Worker | 5878 Farmwood Loop, Wilson, NC 27896 | 2018-06-12 |
1144744517 | Sara Lynn Campbell | Physical Therapist | 3200 Nash Street North, Wilson, NC 27896 | 2017-07-27 |
1902327109 | Lamont Zebediah Barnett | Counselor | 3904 Airport Drive, Wilson, NC 27896 | 2017-06-28 |
1578014718 | Kristy Kaye Rowland | Counselor | 3707 Marion Court N, Wilson, NC 27896 | 2016-10-24 |
1780058057 | Marsha Ricketts Harper | Occupational Therapy Assistant | 3105 Senior Village Lane, Wilson, NC 27896 | 2015-11-24 |
1508122615 | Charlotte Hurt | Social Worker | 910 Raleigh Rd Parkway, Wilson, NC 27896 | 2012-04-03 |
1447542139 | Sarah Elizabeth Kirby Bischoff | Pharmacist | 3401 Raleigh Rd, Harris Teeter, Wilson, NC 27896 | 2011-05-12 |
1235462342 | Wilson Medical Group | Non-Pharmacy Dispensing Site | 3302 Nash St North, Wilson, NC 27896 | 2009-09-09 |
1144341439 | Integrated Family Services, Pllc. | Community/Behavioral Health | 2000 Nash St, Ste E, Wilson, NC 27896 | 2007-04-03 |
Find all providers in zip 27896 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306455126 | A Place 4 Me, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 | 2020-07-28 |
1922623792 | Our Home At Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4601 Waterford Knoll Dr Apt 1724, Charlotte, NC 28226-6015 | 2020-06-08 |
1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
1710443395 | Unity 4 Us Community Outreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 406 Lincoln St, Belmont, NC 28012-3045 | 2019-02-19 |
1871059444 | Believing Everyone Succeeds Together | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 323 Shady Grove Rd, Kings Mtn, NC 28086-9671 | 2019-02-19 |
1740744283 | Tri Plex Industries Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9635 Southern Pine Blvd Ste 154, Charlotte, NC 28273-5564 | 2019-01-29 |
1316415037 | Igr Collaborations | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 212 Pine Ridge Dr, Roanoke Rapids, NC 27870-6832 | 2018-11-12 |
1164924940 | David Douglas Whitfield | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5342 Us Highway 301 North, Micro, NC 27555 | 2018-03-07 |
1710489976 | Moravian Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 North Elm St., Suite 810, Greensboro, NC 27401 | 2018-03-05 |
1659897833 | Shelby Day Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 621 S Dekalb St Ste A, Shelby, NC 28150-6189 | 2017-08-18 |
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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.