CAROLINA RESIDENTIAL SERVICES, INC. (NPI# 1427180975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427180975 |
| Entity Type | Organization |
| Organization Name | CAROLINA RESIDENTIAL SERVICES, INC. |
| Practice Address |
130 Williams St Boonville NC 27011-9300 |
| Mailing Address |
Po Box 286 Rutherford College NC 28671-0286 |
| Practice Telephone | 3363679039 |
| Practice Fax Number | 3363679039 |
| Mailing Telephone | 8285722333 |
| Mailing Fax Number | 9802250500 |
| Enumeration Date | 2007-03-11 |
| 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 | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MHL 099015 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805080 | 05 | |
| NC | 7806585 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629343512 | Carolina Residential Services, Inc. | Community/Behavioral Health | 204 Avery Ave, Morganton, NC 28655-3103 | 2012-03-12 |
| 1619242518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 714 Simmons St, Goldsboro, NC 27530-3843 | 2012-03-12 |
| 1982805933 | Carolina Residential Services, Inc. | Day Training, Developmentally Disabled Services | 126 Commercial Rd, Ahoskie, NC 27910-9469 | 2007-05-29 |
| 1770705956 | Carolina Residential Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 314 East Westbrook Street, Wallace, NC 28466-1533 | 2007-05-03 |
| 1265652754 | Carolina Residential Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2302 Lewis Thomas Rd, Asheboro, NC 27205-1501 | 2007-04-26 |
| 1235261686 | Carolina Residential Services, Inc. | Case Management | 504 E Union St, Morganton, NC 28655-3456 | 2007-03-12 |
| 1053443408 | Carolina Residential Services, Inc. | Case Management | 641 W Main Ave, Taylorsville, NC 28681-2327 | 2007-03-12 |
| 1740312198 | Carolina Residential Services, Inc. | Community/Behavioral Health | 145 N Gilmer St, Mount Airy, NC 27030-3842 | 2007-03-12 |
| 1144352691 | Carolina Residential Services, Inc. | Community/Behavioral Health | 1014 Hay St, Fayetteville, NC 28305-5316 | 2007-03-11 |
| 1063544518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 534 Elk Spur St, Elkin, NC 28621-3206 | 2007-03-11 |
| Street Address |
130 WILLIAMS ST |
| City | BOONVILLE |
| State | NC |
| Zip Code | 27011-9300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306356084 | Healthstat Onsite Clinic Parkdale Plant 25 | Preventive Medicine | 114 Woodruff Road, Boonville, NC 27011 | 2017-10-06 |
| 1942220454 | Quality Care Senior Services, Inc. | Nurse's Aide | 113 B West Main St., Boonville, NC 27011 | 2006-07-20 |
| 1083911705 | Rocky Mountain Holdings LLC | Ambulance | 301 Medical Center Blvd, Winston-salem, NC 27011-7812 | 2011-02-15 |
| 1174979371 | Holly Ann Foster | Massage Therapist | 106 Martin Ave, Boonville, NC 27011-8166 | 2016-05-06 |
| 1184975716 | Yadkin Home Place Six Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 160 River Rd, Boonville, NC 27011-8338 | 2012-09-22 |
| 1811304256 | Carolina Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 160 River Rd, Boonville, NC 27011-8338 | 2014-07-17 |
| 1003966383 | Yadkin County Schools | Psychologist | 3801b River Road, Boonville, NC 27011-8341 | 2007-01-11 |
| 1548679178 | Donald Morgan | Skilled Nursing Facility | 1349 Burton Rd, Boonville, NC 27011-8609 | 2014-08-07 |
| 1578646519 | Walden Associates Inc | Pharmacy | 106 E Main St, Boonville, NC 27011-8764 | 2006-10-23 |
| 1518141506 | Country Love Home Care LLC | Community/Behavioral Health | 2632 Holcomb Rd, Boonville, NC 27011-8834 | 2007-12-26 |
| Find all providers in zip 27011 | ||||
| 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 |
|---|---|---|---|---|
| 1184975716 | Yadkin Home Place Six Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 160 River Rd, Boonville, NC 27011-8338 | 2012-09-22 |
| 1912125295 | Theresea Open Arms | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1277 Sieckmann Ln, Boonville, MO 65233-2216 | 2007-04-23 |
| 1811304256 | Carolina Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 160 River Rd, Boonville, NC 27011-8338 | 2014-07-17 |
| 1851412233 | Unlimited Opportunities Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1620 W Ashley Rd, Boonville, MO 65233-2740 | 2007-04-03 |
| 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 |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
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.