FULL POTENTIAL LIFE LLC (NPI# 1568692127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568692127 |
Entity Type | Organization |
Organization Name | FULL POTENTIAL LIFE LLC |
Practice Address |
1530 N Gregson St Suite 3-d Durham NC 27701-1155 |
Practice Telephone | 9193216171 |
Practice Fax Number | 8888056175 |
Mailing Telephone | 9193216171 |
Mailing Fax Number | 8888056175 |
Enumeration Date | 2009-07-16 |
Last Update Date | 2009-07-16 |
Authorized Official Name | DR. LOGAN GRADDY (PSYCHIATRIST) |
Authorized Official Telephone | 9193216171 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
Street Address |
1530 N GREGSON ST SUITE 3-D |
City | DURHAM |
State | NC |
Zip Code | 27701-1155 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407857816 | Gilfort, Atkinson & Associates | Social Worker | 1530 N Gregson St, Suite 3a, Durham, NC 27701-1155 | 2005-08-09 |
1417192949 | Independently Moving, LLC | Community/Behavioral Health | 1530 N Gregson St, Ste. 2b Bbt Building, Durham, NC 27701-1155 | 2008-12-12 |
1417123845 | Tauchiana Jahnale Vanderbilt | Social Worker | 1530 N Gregson St, Suite 3a, Durham, NC 27701-1155 | 2008-05-06 |
1124214317 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-20 |
1245425156 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-13 |
1720273626 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-13 |
1164617072 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-13 |
1437344348 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-13 |
1255526166 | Dominion Ministries | Community/Behavioral Health | 1530 N Gregson St, Suite 3d, Durham, NC 27701-1155 | 2007-09-13 |
1659573921 | Barbara B Fields | Social Worker | 1530 N Gregson St, Suite 3a, Durham, NC 27701-1155 | 2007-05-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952956179 | Sa'naa Lenoir | Naturopath | 1213 Avondale Drive Suite 4, Durham, NC 27701 | 2019-08-05 |
1225682792 | Sherifat Balogun | Pharmacist | 406 Rigsbee Ave Suite 201, Durham, NC 27701 | 2019-08-01 |
1427575950 | Kristen Kesler Desena | Speech-Language Pathologist | 1105 Englewood Avenue, Durham, NC 27701 | 2017-08-25 |
1295255263 | Tiffany Claire Ashe | Social Worker | 331 W Main St Ste 308, Durham, NC 27701 | 2017-06-21 |
1265815096 | Colleen Hamman | Specialist/Technologist | 616 E Lawson St, Durham, NC 27701 | 2015-06-29 |
1366843286 | Gene Mcphaul | Counselor | 3545 Mayfair St, Durham, NC 27701 | 2014-09-10 |
1245652957 | Michelle Annette Underdue | Social Worker | 801 East Main Street, Suite 2-120, Durham, NC 27701 | 2014-01-15 |
1518306109 | Lincicome Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 300-a Northwood Circle, Durham, NC 27701 | 2013-06-18 |
1669754693 | Ruffin Home 2 | Assisted Living Facility | 830 N. Mangum St., Durham, NC 27701 | 2011-09-15 |
1609192657 | Samaritan Health Center, Inc. | Clinic/Center | 507 E. Knox Street, Durham, NC 27701 | 2010-04-15 |
Find all providers in zip 27701 |
Taxonomy Code | 261QM0850X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adult Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629677547 | Julia Kaplinska, Phd, Pllc | Clinic/Center | 4908 Vistawood Way, Durham, NC 27713-8065 | 2020-10-21 |
1215444161 | C. Patricia Hanley, Ph.d Pllc | Clinic/Center | 13 Jenkins Ct Ste 230, Durham, NH 03824-2324 | 2018-01-01 |
1093038994 | Jones Health Services Inc. | Clinic/Center | 3811 Pickett Rd, Durham, NC 27705-5331 | 2010-03-05 |
1154644342 | Roshaun's House of Care | Clinic/Center | 4012 Guess Rd, Durham, NC 27705-1510 | 2010-03-02 |
1720234495 | Tlc Adult Group Home | Clinic/Center | 401 Moline St, Durham, NC 27707-2347 | 2008-08-13 |
1194866608 | Outreach Home # 4 | Clinic/Center | 3007 Dearborn Dr, Durham, NC 27704-2303 | 2007-02-08 |
1245371939 | Destiny Home, Inc. | Clinic/Center | 630 Rippling Stream Rd, Durham, NC 27704-1233 | 2007-02-08 |
1245856780 | Brightview Psychiatry Solutions Pllc | Clinic/Center | 2232 Page Rd Ste 101, Durham, NC 27703-7724 | 2020-06-21 |
1801429808 | Cbt Institute of North Carolina | Clinic/Center | 1200 Broad St Ste 103, Durham, NC 27705-3576 | 2020-02-18 |
1659859205 | Quantum Resources Consulting | Clinic/Center | 4411 Ben Franklin Blvd, Durham, NC 27704-2147 | 2018-08-04 |
Find all providers in DURHAM |
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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.