CEDARBROOK RESIDENTIAL CENTER, INC. (NPI# 1619012812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619012812 |
| Entity Type | Organization |
| Organization Name | CEDARBROOK RESIDENTIAL CENTER, INC. |
| Practice Address |
1267 Pinnacle Church Rd Nebo NC 28761-5753 |
| Mailing Address |
Po Box 1257 Marion NC 28752-1257 |
| Practice Telephone | 8286524633 |
| Mailing Telephone | 8286524633 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. FRED H LEONARD (PRESIDENT) |
| Authorized Official Telephone | 8286524633 |
| Authorized Official Credential | MS, LPC, NC LIC. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
HAL059021 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804606 | 05 |
| Street Address |
1267 PINNACLE CHURCH RD |
| City | NEBO |
| State | NC |
| Zip Code | 28761-5753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821376542 | The Mcdowell Hospital Inc | Family Medicine | 339 Nebo School Road, Nebo, NC 28761 | 2011-07-29 |
| 1033237532 | Truett Family Care Home | Custodial Care Facility | 728 Nedmcgimsey Rd, Nebo, NC 28761 | 2007-03-26 |
| 1023158565 | Bennick, Inc. | Assisted Living Facility | 405 Jack Corpening Road, Nebo, NC 28761 | 2007-02-07 |
| 1215097357 | Nc Outreach Group Homes, LLC | Intermediate Care Facility, Mentally Retarded | 2121 Old Highway 10 E, Nebo, NC 28761 | 2006-12-11 |
| 1396732236 | Craig Iversen | Psychologist | 1251 Pinnacle Church Road, Nebo, NC 28761 | 2005-10-05 |
| 1497895684 | Bennick, Inc. | Assisted Living Facility | 3341 Old Highway #10, East, Nebo, NC 28761-0001 | 2007-02-07 |
| 1114282282 | Robert Newton | Counselor | 1251 Pinnacle Church Road, Nebo, NC 28761-0964 | 2012-07-05 |
| 1952666026 | Susan Jimison | Registered Nurse | 1251 Pinnacle Church Road, Nebo, NC 28761-0964 | 2012-07-05 |
| 1144606500 | Community Companion Home Care, LLC | Community/Behavioral Health | 3288 Harmony Grove Rd, Nebo, NC 28761-5707 | 2015-08-07 |
| 1831511310 | Robin Stine | Registered Nurse | 1251 Pinnacle Church Rd., Nebo, NC 28761-5753 | 2014-01-17 |
| Find all providers in zip 28761 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033237532 | Truett Family Care Home | Custodial Care Facility | 728 Nedmcgimsey Rd, Nebo, NC 28761 | 2007-03-26 |
| 1710015656 | Gowan Family Care, Inc. | Custodial Care Facility | 82 Ned Mcgimsey Rd, Nebo, NC 28761-6758 | 2007-03-01 |
| 1538689625 | Integrity Mcdowell House, LLC | Custodial Care Facility | 1687 Dairy Dr, Nebo, NC 28761-6810 | 2017-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| 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.