CCDP INC. (NPI# 1316090509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316090509 |
| Entity Type | Organization |
| Organization Name | CCDP INC. |
| Other Organization Name | COASTAL CHILDREN'S DEVELOPMENTAL PROGRAM INC. |
| Practice Address |
2961 Hwy 58 South Pollocksville NC 28573-8755 |
| Mailing Address |
1900 Us Highway 70 E Ste C New Bern NC 28560-6818 |
| Practice Telephone | 2522240320 |
| Practice Fax Number | 2522240320 |
| Mailing Telephone | 2526389046 |
| Mailing Fax Number | 2526389026 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MRS. DONNA B DAVIS (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 2526389046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL052-011 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603132 | 05 |
| Other Name | Type Code |
|---|---|
| Coastal Children's Developmental Program Inc. | Doing Business As Name - Organization |
| Street Address |
2961 HWY 58 SOUTH |
| City | POLLOCKSVILLE |
| State | NC |
| Zip Code | 28573-8755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548489917 | Benjamin Donald Gilmore | Physical Therapist | 215 Foy St, Pollocksville, NC 28573 | 2007-04-24 |
| 1679623607 | Allen Drugs Inc | Pharmacy | 9026 Highway 17, Pollocksville, NC 28573 | 2007-01-11 |
| 1285722777 | Sherry Mattocks Jarman | Counselor | 10774 Highway 17 South, Pollocksville, NC 28573 | 2006-10-10 |
| 1043243835 | Tar Heel Health Care Services, LLC | Home Health | 121 Techcon Way, Pollocksville, NC 28573 | 2006-07-08 |
| 1851385025 | Tammy Waits Stimson | Nurse Practitioner | 137 Medical Ln, Pollocksville, NC 28573 | 2005-09-02 |
| 1245223379 | Jerry Donald Day Jr. | Physician Assistant | 137 Medical Lane, Pollocksville, NC 28573 | 2005-08-24 |
| 1750507786 | Shannon Chambers Semple | Physician Assistant | 137 Medical Lane, Pollocksville, NC 28573 | 2007-04-18 |
| 1487765632 | Gerard M Mcphee | Radiology | 137 Medical Lane, Pollocksville, NC 28573 | 2006-08-31 |
| 1891742763 | Brian Averell | Psychiatry & Neurology | 137 Medical Ln, Pollocksville, NC 28573 | 2006-05-27 |
| 1356336895 | Michael E Davis | Internal Medicine | 137 Medical Lane, Pollocksville, NC 28573 | 2005-09-12 |
| Find all providers in zip 28573 | ||||
| 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 |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
| City | POLLOCKSVILLE |
| Zip Code | 28573 |
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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.