CAROLINA RESIDENTIAL SERVICES, INC. (NPI# 1770705956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770705956 |
| Entity Type | Organization |
| Organization Name | CAROLINA RESIDENTIAL SERVICES, INC. |
| Practice Address |
314 East Westbrook Street Wallace NC 28466-1533 |
| Mailing Address |
Po Box 286 Rutherford College NC 28671-0286 |
| Practice Telephone | 9102855319 |
| Practice Fax Number | 9102855438 |
| Mailing Telephone | 8285722333 |
| Mailing Fax Number | 9802250500 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-06-12 |
| Authorized Official Name | MS. SUSAN M KINCAID (DIRECTOR) |
| Authorized Official Telephone | 8285722333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL 031063 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7806594 | 05 | |
| NC | 7805778 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629343512 | Carolina Residential Services, Inc. | Community/Behavioral Health | 204 Avery Ave, Morganton, NC 28655-3103 | 2012-03-12 |
| 1619242518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 714 Simmons St, Goldsboro, NC 27530-3843 | 2012-03-12 |
| 1982805933 | Carolina Residential Services, Inc. | Day Training, Developmentally Disabled Services | 126 Commercial Rd, Ahoskie, NC 27910-9469 | 2007-05-29 |
| 1265652754 | Carolina Residential Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2302 Lewis Thomas Rd, Asheboro, NC 27205-1501 | 2007-04-26 |
| 1235261686 | Carolina Residential Services, Inc. | Case Management | 504 E Union St, Morganton, NC 28655-3456 | 2007-03-12 |
| 1053443408 | Carolina Residential Services, Inc. | Case Management | 641 W Main Ave, Taylorsville, NC 28681-2327 | 2007-03-12 |
| 1740312198 | Carolina Residential Services, Inc. | Community/Behavioral Health | 145 N Gilmer St, Mount Airy, NC 27030-3842 | 2007-03-12 |
| 1144352691 | Carolina Residential Services, Inc. | Community/Behavioral Health | 1014 Hay St, Fayetteville, NC 28305-5316 | 2007-03-11 |
| 1427180975 | Carolina Residential Services, Inc. | Community/Behavioral Health | 130 Williams St, Boonville, NC 27011-9300 | 2007-03-11 |
| 1063544518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 534 Elk Spur St, Elkin, NC 28621-3206 | 2007-03-11 |
| Street Address |
314 EAST WESTBROOK STREET |
| City | WALLACE |
| State | NC |
| Zip Code | 28466-1533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235330002 | Carolina Residential Services, Inc. | Case Management | 314 East Westbrook Street, Wallace, NC 28466-1533 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326518630 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 114 N Northwood St, Wallace, NC 28466 | 2018-11-29 |
| 1659891232 | Tonia Gray | Registered Nurse | 407 Fremont Street, Burgaw, NC 28466 | 2017-06-23 |
| 1164968889 | Angela Boney | Pharmacist | 5625 S Nc Hwy 41, Wallace, NC 28466 | 2017-01-19 |
| 1790111961 | Realo Discount Drug Stores of Enc, Inc | Pharmacy | 5655 S Nc 41 Hwy, Wallace, NC 28466 | 2013-09-19 |
| 1699938993 | The Lawsons House | Clinic/Center | 116 West Main St, Wallace, NC 28466 | 2008-07-07 |
| 1184842098 | Continuum Care Corporation | Assisted Living Facility | 1052 Ne Railroad St., Wallace, NC 28466 | 2007-04-23 |
| 1467677229 | Pigfords Physical Therapy Assoc Inc | Physical Therapist | 112 E Medical Village Dr, Wallace, NC 28466 | 2007-04-16 |
| 1598875379 | Wilson Family Pharmacies Inc | Pharmacy | 116 East Main St, Wallace, NC 28466 | 2006-08-30 |
| 1659317394 | Axon Darren Sholar | Dentist | 522 S Norwood St, Wallace, NC 28466 | 2006-06-21 |
| 1083121396 | Kelsey Lynn Vallee | Pharmacist | 5717 S Nc 41 Hwy, Wallace, NC 28466 | 2018-01-08 |
| Find all providers in zip 28466 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720273337 | House of New Beginning of Duplin | Community Based Residential Treatment Facility, Mental Illness | 808 Miami Ave, Wallace, NC 28466-2530 | 2007-09-07 |
| 1184776189 | Helping Hands Care Management Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 517 S Norwood St, Wallace, NC 28466-1619 | 2007-01-18 |
| 1114161403 | Christian's House of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 115 East Main Street, Wallace, NC 28466-2746 | 2009-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| 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.