LYDIA'S HOME (NPI# 1205011012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205011012 |
| Entity Type | Organization |
| Organization Name | LYDIA'S HOME |
| Practice Address |
2704 Grimsley St Greensboro NC 27403-3138 |
| Practice Telephone | 3364567248 |
| Mailing Telephone | 3364567248 |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | MS. MELISSA LEGETTE (OWNER) |
| Authorized Official Telephone | 3364567248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL041850 | NC | Residential Treatment Facilities |
| Street Address |
2704 GRIMSLEY ST |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27403-3138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518581412 | Tina Tate | Nurse Practitioner | Behavioral Health Hospital, 700 Walter Reed Drive, Greensboro, NC 27403 | 2020-06-05 |
| 1609438514 | Gail Corneau | Psychologist | Uncg Psychology Clinic, 1100 West Market Street, Greensboro, NC 27403 | 2019-07-01 |
| 1528527298 | Kendall Austin Macdonald | Hearing Instrument Specialist | 2823 A Spring Garden St, Suite A, Greensboro, NC 27403 | 2019-03-13 |
| 1093292237 | Andrew Robertson | Pharmacist | 1903 W. Florida St, Greensboro, NC 27403 | 2018-07-20 |
| 1447778071 | Bac Developmental Program Inc | Day Training, Developmentally Disabled Services | 2203 Coliseum Blvd, Greensboro, NC 27403 | 2017-09-04 |
| 1144607128 | Waldo's Optical | Eyewear Supplier (Equipment, not the service) | 2500 Spring Garden St., Suite C, Greensboro, NC 27403 | 2015-04-29 |
| 1851703144 | Tedra Slade | Social Worker | 612 Pasteur Dr., Suite 300, Greensboro, NC 27403 | 2014-05-21 |
| 1336568807 | Brian Sninsky | Urology | Alliance Urology Specialists, Pa, 509 N. Elam Ave., 2nd Floor, Greensboro, NC 27403 | 2014-04-14 |
| 1003237785 | Peter Reich | Counselor | 907 Englewood St, Greensboro, NC 27403 | 2013-12-23 |
| 1508295429 | Alexander Wilson Lpc Inc | Counselor | 3719 West Market Street, Suite B, Greensboro, NC 27403 | 2013-11-01 |
| Find all providers in zip 27403 | ||||
| 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 |
|---|---|---|---|---|
| 1568693778 | Zenith Providers | Residential Treatment Facility, Emotionally Disturbed Children | 3802 Broadacres Dr, Greensboro, NC 27407-6502 | 2009-08-05 |
| 1013148519 | Zenith Providers, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7 Kelley Ct, Greensboro, NC 27401-4679 | 2009-07-31 |
| 1811125669 | Hope House Restoration Center | Residential Treatment Facility, Emotionally Disturbed Children | 4102 Cornerrock Dr, Greensboro, NC 27406-8586 | 2009-06-30 |
| 1952539314 | Keystone Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4411 Belfield Dr, Greensboro, NC 27405-6313 | 2009-06-24 |
| 1548497795 | Fresh Start Service Support | Residential Treatment Facility, Emotionally Disturbed Children | 4708 Meadowcroft Rd, Greensboro, NC 27406-8085 | 2009-06-15 |
| 1396970521 | Safe-haven House II, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 4202 Old Liberty Place, Safe-haven House II, LLC, Greensboro, NC 27406-7218 | 2009-05-18 |
| 1407090392 | New Beginnings | Residential Treatment Facility, Emotionally Disturbed Children | 5709 Northlake Dr, Greensboro, NC 27410-2630 | 2009-04-23 |
| 1720222615 | Garden Lakes | Residential Treatment Facility, Emotionally Disturbed Children | 3824 Yanceyville St, Greensboro, NC 27405-3348 | 2009-04-23 |
| 1588801294 | Victory House | Residential Treatment Facility, Emotionally Disturbed Children | 804 Quail Cove Ct, Greensboro, NC 27406-8082 | 2009-01-16 |
| 1215181953 | New Life Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 112 Corliss St, Greensboro, NC 27406-5208 | 2008-11-07 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27403 |
Please comment or provide details below to improve the information on LYDIA'S HOME.
| 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.