TEEN SCENE ACT 3 (NPI# 1639352826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639352826 |
| Entity Type | Organization |
| Organization Name | TEEN SCENE ACT 3 |
| Practice Address |
114 B Hollycrest Lane Gastonia NC 28056-9008 |
| Mailing Address |
708 S Chestnut St Gastonia NC 28054-4548 |
| Practice Telephone | 7048544840 |
| Mailing Telephone | 7048544840 |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-12 |
| Authorized Official Name | CHANDA TRUESDELL (OWNER) |
| Authorized Official Telephone | 7048544840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-036-182 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6604134 | 05 |
| Street Address |
114 B HOLLYCREST LANE |
| City | GASTONIA |
| State | NC |
| Zip Code | 28056-9008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164983276 | Emily Victoria Woods | Behavior Technician | 973 Plantation Trail, Gastonia, NC 28056 | 2019-03-29 |
| 1851888333 | Tapas Patel | Dentist | 4008 E Franklin Blvd Ste 100, Gastonia, NC 28056 | 2018-04-19 |
| 1952814303 | Humana Pharmacy Inc | Pharmacy | 2910-1 E. Franklin Blvd, Gastonia, NC 28056 | 2017-11-08 |
| 1063958429 | Rachel Zhisheng Toelkes | Specialist/Technologist | 457 Linsbury Ct., Gastonia, NC 28056 | 2017-01-10 |
| 1669846200 | Kathryn Carol O'neil | Physician Assistant | 3302 S New Hope Rd Ste 100b, Gastonia, NC 28056 | 2015-11-19 |
| 1447518618 | Shanta Janernita Lindsay | Nurse Anesthetist, Certified Registered | 1140 Safeway Dr, Gastonia, NC 28056 | 2012-04-25 |
| 1679883250 | Sabrina M Kuiken | Pharmacist | 2500 E. Franklin Blvd, Gastonia, NC 28056 | 2010-10-15 |
| 1528378429 | Katherine Carpenter Hovis | Pharmacist | 2601 South New Hope Rd, Gastonia, NC 28056 | 2010-10-14 |
| 1457584237 | Jonathan C. Allen Jr. | Dentist | 2924 East Franklin Blvd, Gastonia, NC 28056 | 2009-08-27 |
| 1558593822 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3658 South New Hope Rd, Gastonia, NC 28056 | 2009-08-19 |
| Find all providers in zip 28056 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1356616890 | Steps for Success Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1024 Junius St, Gastonia, NC 28052-1189 | 2012-03-16 |
| 1982981882 | New Transition LLC | Residential Treatment Facility, Emotionally Disturbed Children | 1589 Rolling Meadow Ln, Gastonia, NC 28054-6325 | 2011-11-07 |
| 1770810301 | Focus Point | Residential Treatment Facility, Emotionally Disturbed Children | 1664 Plyler Lake Rd, Gastonia, NC 28054-3603 | 2009-11-03 |
| 1053552778 | New Beginnings Residential Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 413 S Webb St, Gastonia, NC 28052-3600 | 2009-03-09 |
| 1689828097 | Steps for Success Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 927 Floyd Ln, Gastonia, NC 28052-2700 | 2008-11-12 |
| 1982854360 | Innerchange Youth Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 724 Raindrops Rd, Gastonia, NC 28054-1779 | 2008-09-23 |
| 1720261910 | Kids Depot | Residential Treatment Facility, Emotionally Disturbed Children | 100 May St, Gastonia, NC 28052-0407 | 2007-12-11 |
| 1427277524 | New Place, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1628 Rankin Lake Rd, Gastonia, NC 28052-1888 | 2007-04-25 |
| 1275652430 | New Genesisi Residential Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 300 Downey Pl, Gastonia, NC 28054-3903 | 2007-03-28 |
| Find all providers in GASTONIA | ||||
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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.