EXTENDED REACH DAYTREATMENT FOR CHILDRENA AND ADOLESCENTS LLC (NPI# 1740587591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740587591 |
| Entity Type | Organization |
| Organization Name | EXTENDED REACH DAYTREATMENT FOR CHILDRENA AND ADOLESCENTS LLC |
| Practice Address |
302 Bradford Ave Fayetteville NC 28301-5406 |
| Practice Telephone | 9104840095 |
| Practice Fax Number | 9192387287 |
| Mailing Telephone | 9104840095 |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-14 |
| Authorized Official Name | MR. ANDREA MONIQUE BOATMAN-HALL (CEO) |
| Authorized Official Telephone | 9102298256 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8302339 | 05 | |
| NC | 6006927 | 05 | |
| NC | 8302981 | 05 |
| Street Address |
302 BRADFORD AVE |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301-5406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811128507 | Reaching Out and Beyond LLC | Community/Behavioral Health | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2009-07-29 |
| 1497125363 | Lisa Daniels | Social Worker | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2015-10-04 |
| 1245623396 | Kerstin Sheets | Social Worker | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2015-03-13 |
| 1932507159 | Sue Hunt | Social Worker | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2014-12-22 |
| 1215330378 | Samantha Mcqueen | Social Worker | 302 Bradford Ave, Suite 2, Fayetteville, NC 28301-5406 | 2014-10-03 |
| 1801133350 | John Wayne Edwards | Counselor | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2013-01-03 |
| 1891048757 | Natifa Pettus | Social Worker | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2012-10-17 |
| 1124388285 | Crse Advanced Placement Homes, Inc. | Community/Behavioral Health | 302 Bradford Ave, Fayetteville, NC 28301-2643 | 2012-05-23 |
| 1821395674 | Extended Reach Daytreatment for Children and Adolescents | Community/Behavioral Health | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2011-02-14 |
| 1538465604 | Extended Reach Day Treatment for Children & Adolescents LLC | Community/Behavioral Health | 302 Bradford Ave, Fayetteville, NC 28301-5406 | 2011-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499944 | Goal Digger Network LLC | Case Management | 5220 Delco St, Fayetteville, NC 28311-2332 | 2020-08-27 |
| 1437799178 | Brickhouse Management | Case Management | 2529 Raeford Rd Ste C-8, Fayetteville, NC 28305-5098 | 2020-01-10 |
| 1255828612 | Working Concepts Inc | Case Management | 110 Habersham Dr Ste 325, Fayetteville, GA 30214-1381 | 2018-04-20 |
| 1831569268 | Daybreak Case Management Services | Case Management | 110 Hunters Gln, Fayetteville, GA 30215-1914 | 2015-09-28 |
| 1073999538 | Aci Support Specialists, Inc. | Case Management | 257 Kenwood Dr, Fayetteville, NC 28311-0833 | 2015-08-07 |
| 1811323595 | Aci Support Specialists | Case Management | 1619 Winnabow Drive, Fayetteville, NC 28304 | 2013-09-25 |
| 1518393297 | Aci Support Specialists | Case Management | 2257 Spindletree Drive, Fayetteville, NC 28304 | 2013-09-25 |
| 1891121588 | Aci Support Specialists | Case Management | 2633 Gressitt Point Ln, Fayetteville, NC 28306-3555 | 2013-09-25 |
| 1568801355 | Aci Support Specialists, Inc. | Case Management | 342 Wagoner Dr, Suite 107, Fayetteville, NC 28303-4686 | 2013-06-14 |
| 1164787248 | Conceive Believe&achieve LLC | Case Management | 6380 Cliffdale Rd Unit 25032, Fayetteville, NC 28314-2970 | 2012-07-05 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
Please comment or provide details below to improve the information on EXTENDED REACH DAYTREATMENT FOR CHILDRENA AND ADOLESCENTS LLC.
| 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.