KING CERTIFIED RESIDENTIAL FACILITY (NPI# 1497910244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497910244 |
| Entity Type | Organization |
| Organization Name | KING CERTIFIED RESIDENTIAL FACILITY |
| Practice Address |
4008 Flatwoods Road Northport AL 35473-1101 |
| Mailing Address |
4008 Flatwoods Rd Northport AL 35473-1101 |
| Practice Telephone | 2057927829 |
| Mailing Telephone | 2057927829 |
| Mailing Fax Number | 2053301359 |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |
| Authorized Official Name | RENEE KING HOLLEY (FAMILY PROVIDER) |
| Authorized Official Telephone | 2057927829 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5324343 | AL | Residential Treatment Facilities |
| Street Address |
4008 FLATWOODS ROAD |
| City | NORTHPORT |
| State | AL |
| Zip Code | 35473-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002396 | Lacedric Crawford | Chore Provider | 13055 Garden Creek Lane, Northport, AL 35473 | 2020-08-10 |
| 1316585219 | Cerra Jordan Jackson | Family Medicine | 5710 Watermelon Road, Suite 600, Northport, AL 35473 | 2019-12-11 |
| 1033609748 | Kara Lynne Pate | Nurse Practitioner | 5710 Watermelon Rd Ste 600, Northport, AL 35473 | 2018-05-17 |
| 1134619059 | Vanessa Graves | Social Worker | 521 Energy Center Blvd Ste 1506, Northport, AL 35473 | 2018-05-16 |
| 1164930939 | Brandi Nail Hubbard | Family Medicine | 5004 Al-69, Northport, AL 35473 | 2018-01-16 |
| 1831554104 | Danielle Paulos | Pharmacist | 5137 Northcliff Dr, Northport, AL 35473 | 2015-12-30 |
| 1629497508 | Lauren Hanley | Nurse Practitioner | 4280 Watermelon Rd Ste 110, Northport, AL 35473 | 2014-04-08 |
| 1528372802 | Communication Advantage | Speech-Language Pathologist | 507 Energy Center Blvd Suite 301, West Al Speech Pathology, Northport, AL 35473 | 2010-07-29 |
| 1144467309 | Caroline J Day | Family Medicine | 5710 Watermelon Road, Suite 600, Northport, AL 35473 | 2009-01-09 |
| 1538311196 | Northridge Dialysis Center, LLC | Clinic/Center | 4400 Watermelon Road, Northport, AL 35473 | 2008-10-15 |
| Find all providers in zip 35473 | ||||
| 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 |
|---|---|---|---|---|
| 1356858930 | Latoya Mckinstry | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3914 Watermelon Rd, Northport, AL 35473-5184 | 2018-01-04 |
| 1689988891 | James River Sclh | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5505 James River Dr, Northport, AL 35473-1309 | 2010-07-29 |
| 1619484904 | Virtuous Women of West Alabama | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3914 Watermelon Rd, Northport, AL 35473-5184 | 2018-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184236721 | Nekiya Jones | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 417 Fox Run Lane, Pell City, AL 35125-9366 | 2020-08-17 |
| 1952926230 | Ouicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 117 E Forest Ave, Troy, AL 36081-4501 | 2020-06-11 |
| 1194352120 | Montessori Mental Health LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 209 Glen Meadow Ln, Harvest, AL 35749-8995 | 2020-03-27 |
| 1467098681 | Fhl Group Home,llc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12218 Spring Rd, Tanner, AL 35671-3214 | 2019-11-22 |
| 1972021970 | Volunteers of America Southeast | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1204 Hillcrest Rd, Mobile, AL 36695-3930 | 2017-08-30 |
| 1316463144 | Answered Prayer Home Care Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4101 Wall St Ste C, Montgomery, AL 36106-3724 | 2017-08-14 |
| 1851813422 | Ericka Letoindia Betton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1554 Basil St, Mobile, AL 36603-5019 | 2017-07-14 |
| 1740719566 | Yvette Renee Fuller | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 102 Populus Dr, Harvest, AL 35749-4802 | 2017-06-06 |
| 1790134757 | Three Folds Care Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6336 Taylor Ridge Rd, Montgomery, AL 36116-6507 | 2016-06-09 |
| 1427411354 | Independence Accessible Housing LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1401 11th St S, Birmingham, AL 35205-4613 | 2016-03-29 |
| Find all providers with the same taxonomy | ||||
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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.