OUR FATHERS PLACE INC (NPI# 1275637423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275637423 |
| Entity Type | Organization |
| Organization Name | OUR FATHERS PLACE INC |
| Practice Address |
256 East Broad Street Statesville NC 28677 |
| Practice Telephone | 7048720313 |
| Practice Fax Number | 7048727787 |
| Mailing Telephone | 7048720313 |
| Mailing Fax Number | 7048727787 |
| Enumeration Date | 2006-09-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JAMES RUSSELL LINTON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7046840197 |
| Authorized Official Credential | MED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 320800000X | Community Based Residential Treatment Facility, Mental Illness | NC | Residential Treatment Facilities | |
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603681 | 05 | |
| NC | 6603748 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346303187 | Our Fathers Place Inc | Residential Treatment Facility, Emotionally Disturbed Children | 413 Stockton Street, Statesville, NC 28677-5325 | 2006-12-19 |
| 1831252675 | Our Fathers Place Inc | Residential Treatment Facility, Emotionally Disturbed Children | 115 North Oakwood Drive, Stateville, NC 28677-5325 | 2006-12-19 |
| 1679741714 | Our Fathers Place Inc | Community/Behavioral Health | 256 East Broad Street, Statesville, NC 28677-5325 | 2008-02-12 |
| Street Address |
256 EAST BROAD STREET |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679741714 | Our Fathers Place Inc | Community/Behavioral Health | 256 East Broad Street, Statesville, NC 28677-5325 | 2008-02-12 |
| 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 | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669780912 | The Shepherd's Watch, Inc | Community Based Residential Treatment Facility, Mental Illness | 129 Redemption Rd, Statesville, NC 28625-1526 | 2010-09-21 |
| 1942411442 | Barium Springs Home for Children | Community Based Residential Treatment Facility, Mental Illness | 115 Barium Springs Drive, Nelson Home, Statesville, NC 28677-6238 | 2007-05-25 |
| 1780807735 | The Mental Health Association In North Carolina, Inc. | Community Based Residential Treatment Facility, Mental Illness | 711 Brookdale Dr, Statesville, NC 28677-3405 | 2007-04-10 |
| 1316038375 | You-turn, Inc | Community Based Residential Treatment Facility, Mental Illness | 117 Old Mountain Rd, Statesville, NC 28677-2062 | 2006-09-27 |
| 1396288585 | Shekinah Resource Foundation | Community Based Residential Treatment Facility, Mental Illness | 301 S Oakland Ave, Unit 6444, Statesville, NC 28687-0837 | 2016-11-21 |
| 1982744439 | You-turn, Inc | Community Based Residential Treatment Facility, Mental Illness | 117 Old Mountain Rd, Statesville, NC 28677-2062 | 2007-02-07 |
| 1790825248 | You-turn, Inc | Community Based Residential Treatment Facility, Mental Illness | 117 Old Mountain Rd, Statesville, NC 28677-2062 | 2007-02-07 |
| 1609916154 | You-turn, Inc | Community Based Residential Treatment Facility, Mental Illness | 117 Old Mountain Rd, Statesville, NC 28677-2062 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
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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.