ROSE OF SHARON ADOLESCENT TREATMENT HOME (NPI# 1194871483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194871483 |
| Entity Type | Organization |
| Organization Name | ROSE OF SHARON ADOLESCENT TREATMENT HOME |
| Practice Address |
13 Rhyn Ct Durham NC 27704-2359 |
| Mailing Address |
161 Kentucky Derby Dr Clayton NC 27520-6080 |
| Practice Telephone | 9192202492 |
| Practice Fax Number | 9195502648 |
| Mailing Telephone | 9195502648 |
| Mailing Fax Number | 9192201185 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MRS. SHARON W PETTIFORD (CEO-OWNER) |
| Authorized Official Telephone | 9195502648 |
| Is Organization Subpart | Y |
| Parent Organization Name | ROSE OF SHARON ADOLESCENT TREATMENT HOME |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL 032275 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603291 | 05 |
| Street Address |
13 RHYN CT |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891019345 | Purposely Driven By Hope Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2720 Wedgedale Ave, Durham, NC 27703-3345 | 2010-03-25 |
| 1235453366 | Striving for Excellence Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 3704 Four Seasons Dr, Durham, NC 27707-4724 | 2010-03-18 |
| 1194051110 | Herbert Way of Living, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 810 Cartman Dr, Durham, NC 27704-2318 | 2009-10-27 |
| 1639310238 | Visions of Hope Adolescent Center, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3633 Glidewell Ct, Durham, NC 27707-6044 | 2009-03-12 |
| 1285874909 | Freddie Lee Williams | Residential Treatment Facility, Emotionally Disturbed Children | 3671 Guess Rd, Durham, NC 27705-6908 | 2009-02-21 |
| 1134366388 | Kinder Love Homs | Residential Treatment Facility, Emotionally Disturbed Children | 1202 Ellis Rd, Durham, NC 27703-6027 | 2009-01-09 |
| 1891931044 | Another Chance Residential, LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 232 Ruby Ridge Rd, Durham, NC 27703-4661 | 2008-12-17 |
| 1821261389 | S Martin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2 Isaacs Way, Durham, NC 27713-3465 | 2008-04-05 |
| 1366611584 | Mckinley's Better Living Residential Services | Residential Treatment Facility, Emotionally Disturbed Children | 104 Putnam Ln, Durham, NC 27713-2316 | 2008-02-21 |
| 1154513141 | The Greenhouse, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 224 Overlook Ave, Durham, NC 27712-2829 | 2007-08-14 |
| Find all providers in DURHAM | ||||
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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.