MARY'S HOME (NPI# 1215338231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215338231 |
| Entity Type | Organization |
| Organization Name | MARY'S HOME |
| Practice Address |
1808 Birchwood Dr Se Wilson NC 27893-6476 |
| Practice Telephone | 2523479705 |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |
| Authorized Official Name | MS. DOMINIQUE TIARRA JONES (OWNER AND DIRECTOR) |
| Authorized Official Telephone | 2523479705 |
| Authorized Official Credential | CNA MED TECH, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | .1300 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043410103 | Mary's Home | Assisted Living Facility | 14158 Nw 88th Pl, Miami Lakes, FL 33018-7358 | 2007-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARY'S HOME CARE SERVICES | 224 Ward Loop, Hemingway, SC 29554-3415 |
| Alabama Business Registrations | Mary's Home Care, Inc. | 110 Coosada Dr, Montgomery, AL 36117 |
| Alabama Business Registrations | MARY'S HOME COOKING & CATERING, LLC | 25 West Oxmoor Road, Homewood, AL 35209 |
| Oregon Corporations, Companies and Business Names | MARY'S HOME SALES, LLC | 4035 Sw Stephenson Street, Portland, OR 97219 |
| Vermont Business Registrations | MARY'S HOMEMADE | 7 Westminster Street, Saxtons River, VT 05154 |
| Colorado Liquor Licenses | MARY'S HOMESTYLE COOKING | 230 Lynwood Street Unit G & H, Grand Junction, CO 81503 |
| Street Address |
1808 BIRCHWOOD DR SE |
| City | WILSON |
| State | NC |
| Zip Code | 27893-6476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847524 | Graceland Student Services LLC | Early Intervention Provider Agency | 610 Fairview Ave., Wilson, NC 27893 | 2020-09-30 |
| 1508477894 | Evan Michael Abatiell | Specialist/Technologist | 400 Atlantic Christian E West Ne, Wilson, NC 27893 | 2020-08-11 |
| 1679100606 | Newgreen Inhomecare Group Inc | Registered Nurse | 121 Nast Street N, Wilson, NC 27893 | 2020-03-27 |
| 1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
| 1679043244 | Madison Rose Propst | Social Worker | 2416 Bedgood, Wilson, NC 27893 | 2018-11-27 |
| 1104396753 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2500 Horton Blvd, Wilson, NC 27893 | 2018-11-27 |
| 1528545498 | North Carolina In-home Partner-viii, LLC | Home Health | 1901 Tarboro St Sw Ste 304, Wilson, NC 27893 | 2018-07-24 |
| 1518478957 | Home Away From Home, Inc. | In Home Supportive Care | 1723 Meadowbrook Lane W., Wilson, NC 27893 | 2017-10-12 |
| 1942721295 | Sandra Susan Blazek | Social Worker | 608 Nash Street Nw, Wilson, NC 27893 | 2017-06-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| Find all providers in zip 27893 | ||||
| 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 |
|---|---|---|---|---|
| 1447594304 | Carepointe Behavioral Health Services | Residential Treatment Facility, Emotionally Disturbed Children | 501 Spaulding St Se, Wilson, NC 27893-6455 | 2012-11-15 |
| 1801159447 | Region V Boces | Residential Treatment Facility, Emotionally Disturbed Children | 3850 North Wilderness Drive, Wilson, WY 83014-0240 | 2012-06-19 |
| 1831324284 | Phillips Residential Care | Residential Treatment Facility, Emotionally Disturbed Children | 305 Thurston Dr W, Wilson, NC 27893-2854 | 2009-05-28 |
| 1437390341 | First Step Residential Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1009 Lodge St S, Wilson, NC 27893-5801 | 2009-03-23 |
| 1992945828 | Elegant Ladies of The Future, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3720 Martha Ln N, Wilson, NC 27896-8636 | 2009-03-05 |
| 1811135346 | Second Chance Residential Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3310 Martin Luther King Jr Pkwy Se, Wilson, NC 27893-9599 | 2009-01-21 |
| 1881873420 | Abundance of Love Children's Homes | Residential Treatment Facility, Emotionally Disturbed Children | 1712 Parkway St W, Wilson, NC 27893-2733 | 2007-10-31 |
| 1144414780 | Teton Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 7905 S. Fall Creek Rd., Wilson, WY 83014-0290 | 2007-08-28 |
| 1578685863 | C-v Ranch Region V Boces | Residential Treatment Facility, Emotionally Disturbed Children | 3850 N. Wilderness Dr., Wilson, WY 83014 | 2007-04-06 |
| 1831442201 | Region V Board of Cooperative Educational Services | Residential Treatment Facility, Emotionally Disturbed Children | 3850 North Wilderness Drive, Wilson, WY 83025 | 2012-10-22 |
| Find all providers in WILSON | ||||
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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.