FULL POTENTIAL LIFE LLC


Address: 1530 N Gregson St, Suite 3-d, Durham, NC 27701-1155
Phone: 9193216171

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities

Office Location

Street Address 1530 N GREGSON ST
SUITE 3-D
City DURHAM
State NC
Zip Code 27701-1155

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QM0850X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Mental Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
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Competitor

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City DURHAM
Zip Code 27701

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Dataset Information

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.

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