CAROLINA RESIDENTIAL SERVICES, INC (NPI# 1265575971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265575971 |
| Entity Type | Organization |
| Organization Name | CAROLINA RESIDENTIAL SERVICES, INC |
| Practice Address |
804 Hunter St Statesville NC 28677-3530 |
| Mailing Address |
Po Box 286 Rutherford College NC 28671-0286 |
| Practice Telephone | 7048830850 |
| Practice Fax Number | 7048739502 |
| Mailing Telephone | 8285722333 |
| Mailing Fax Number | 9802250500 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-07-20 |
| Authorized Official Name | MS. SUSAN M KINCAID (DIRECTOR) |
| Authorized Official Telephone | 8285722333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MHL-049-063 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7806597 | 05 | |
| NC | 7803401 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063555886 | Carolina Residential Services, Inc | Community/Behavioral Health | 310 Burke Dr, Morganton, NC 28655-5395 | 2007-02-14 |
| 1497898183 | Carolina Residential Services, Inc | Community/Behavioral Health | 413 Glancy St, Swansboro, NC 28584-9656 | 2007-02-14 |
| 1700929445 | Carolina Residential Services, Inc | Community/Behavioral Health | 910 Spring St, Mount Airy, NC 27030-5512 | 2007-02-14 |
| 1952444747 | Carolina Residential Services, Inc | Community/Behavioral Health | 103 S Front St, Warsaw, NC 28398-1832 | 2007-02-14 |
| 1104969989 | Carolina Residential Services, Inc | Community/Behavioral Health | 307 Giddens St, Clinton, NC 28328-3413 | 2007-02-14 |
| 1447393277 | Carolina Residential Services, Inc | Community/Behavioral Health | 933 W Main Ave, Taylorsville, NC 28681-2366 | 2007-02-14 |
| 1497898159 | Carolina Residential Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 301 W Camden St, Windsor, NC 27983-1828 | 2007-02-14 |
| 1275676959 | Carolina Residential Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 516 Church St E, Ahoskie, NC 27910-3524 | 2007-02-14 |
| 1326181827 | Carolina Residential Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 112 Cherry Street, Woodland, NC 27897-0717 | 2007-02-14 |
| 1811030463 | Carolina Residential Services, Inc | Community/Behavioral Health | 730 N Mulberry St, Statesville, NC 28677-3233 | 2007-02-14 |
| Street Address |
804 HUNTER ST |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 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 |
| 1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
| 1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
| 1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
| 1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
| 1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
| 1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
| 1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
| 1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
| Find all providers in zip 28677 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1164973483 | Quest Provider Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 344 Wilson St, Statesville, NC 28677-3860 | 2016-10-21 |
| 1063793792 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 333 Massey Deal Rd, Statesville, NC 28625-8823 | 2011-09-08 |
| 1972884609 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 234 Scotts Creek Rd, Statesville, NC 28625-2342 | 2011-09-08 |
| 1225319304 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 304 Gregory Rd, Statesville, NC 28677-3106 | 2011-09-02 |
| 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 |
| 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 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
Please comment or provide details below to improve the information on CAROLINA RESIDENTIAL SERVICES, INC.
| 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.