SHEKINAH RESOURCE FOUNDATION (NPI# 1396288585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396288585 |
| Entity Type | Organization |
| Organization Name | SHEKINAH RESOURCE FOUNDATION |
| Practice Address |
301 S Oakland Ave Unit 6444 Statesville NC 28687-0837 |
| Mailing Address |
450 W Hanes Mill Rd 222 Winston Salem NC 27105-9141 |
| Practice Telephone | 3367473479 |
| Mailing Telephone | 3367473479 |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |
| Authorized Official Name | KEVIN A. SMITH (CEO) |
| Authorized Official Telephone | 3367473479 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 27780134 | NC | Residential Treatment Facilities |
| Y | 385HR2050X |
Respite Care Specialization: Respite Care Camp |
27780134 | NC | Respite Care Facility |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154780724 | Shekinah Resource Foundation | Non-emergency Medical Transport (VAN) | 301 S Oakland Ave, Ste 6444, Statesville, NC 28687-0837 | 2016-02-11 |
| 1124488200 | Shekinah Resource Foundation | Non-emergency Medical Transport (VAN) | 450 W Hanes Mill Rd, Ste 222, Winston Salem, NC 27105-9141 | 2016-03-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHEKINAH RESOURCE FOUNDATION | 450 W Hanes Mill Rd Ste 222, Winston Salem, NC 27105-7404 |
| Street Address |
301 S OAKLAND AVE UNIT 6444 |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28687-0837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154780724 | Shekinah Resource Foundation | Non-emergency Medical Transport (VAN) | 301 S Oakland Ave, Ste 6444, Statesville, NC 28687-0837 | 2016-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671781 | Jennifer Joanne Lippel | Counselor | 117 Lone Poplar Dr, Statesville, NC 28625-5029 | 2020-08-27 |
| 1043823396 | Ketwan Kareem Graham | Social Worker | 474 N Center St, Statesville, NC 28677-4022 | 2020-08-26 |
| 1548887706 | Tasha Marie Vangile | Nurse Practitioner | 120 Westview Ln, Statesville, NC 28625-8221 | 2020-07-02 |
| 1861014797 | Savannah Jane Nevarez | Counselor | 1450 Fern Creek Dr, Statesville, NC 28625-9376 | 2020-05-14 |
| 1235758517 | Pedro Ariel Blanco | Physical Therapist | 1905 E Broad St, Statesville, NC 28625-4309 | 2020-04-15 |
| 1376170829 | Urvi J. Patel | Student in an Organized Health Care Education/Training Program | 102 Feimster St, Statesville, NC 28677-5204 | 2020-03-25 |
| 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 |
| 1699300822 | Carolinas Regenerative Medicine, Pllc | Family Medicine | 1661 Davie Ave, Statesville, NC 28677-3519 | 2020-03-09 |
| 1730714163 | Sandra Lourdes Mayta | Counselor | 1450 Fern Creek Drive, Statesville, NC 28625 | 2020-03-05 |
| Find all providers in STATESVILLE | ||||
| Taxonomy Code | 385HR2050X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care Camp |
| A camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g., those with developmental delays, mental retardation, mental/behavioral disorders). The staff must have training in working with the target populations and dealing with emergency situations which might be related to or exacerbate the individual's condition. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487111977 | Shanise Danielle Lewis | Respite Care | Top Notch Nurse Staffing & Home Health LLC., 2015 Ayrsley Town Blvd. Suite 202, Charlotte, NC 28273 | 2019-02-21 |
| 1043755978 | Peaceful Living Home Care, LLC | Respite Care | 610 Upwey Ct, Rolesville, NC 27571-9218 | 2017-01-02 |
| City | STATESVILLE |
| Zip Code | 28687 |
Please comment or provide details below to improve the information on SHEKINAH RESOURCE FOUNDATION.
| 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.