SKILL CREATIONS OF KENANSVILLE (NPI# 1801147186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801147186 |
| Entity Type | Organization |
| Organization Name | SKILL CREATIONS OF KENANSVILLE |
| Practice Address |
218 S Stokes Street Kenansville NC 28349-0001 |
| Mailing Address |
Po Box 1636 Goldsboro NC 27533-1636 |
| Practice Telephone | 9102960078 |
| Mailing Telephone | 9197347398 |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | PAUL HACKMANN (CEO) |
| Authorized Official Telephone | 9197347398 |
| Is Organization Subpart | Y |
| Parent Organization Name | SKILL CREATIONS INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | MHL-031-004 | NC | Nursing & Custodial Care Facilities |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | MHL-031-004 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406370 | 05 |
| Street Address |
218 S STOKES STREET |
| City | KENANSVILLE |
| State | NC |
| Zip Code | 28349-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255820494 | Ashley Thigpen Kennedy | Occupational Therapist | 514 South Main Street, Kenansville, NC 28349 | 2018-05-03 |
| 1508387531 | Jeffery None Lowery | Speech-Language Pathologist | Vidant Duplin Rehabillitation, 514 S. Main Street, Kenansville, NC 28349 | 2017-06-29 |
| 1013269786 | Primary Health Choice, Inc. | Counselor | 302 North Main Street. Suite 2, Kenansville, NC 28349 | 2012-10-05 |
| 1104191907 | Duplin County Schools | Local Education Agency (LEA) | 315 N. Main St., Kenansville, NC 28349 | 2012-03-13 |
| 1841579844 | Ashley Barnes Ezzell | Pharmacist | 134 Liberty Square, Suite B, Kenansville, NC 28349 | 2011-08-08 |
| 1265767172 | Goshen Medical Center, Inc. | Clinic/Center | 212 Duplin St, Kenansville, NC 28349 | 2009-10-09 |
| 1497986509 | Duplin General Hospital, Incorporated | Licensed Practical Nurse | 401 North Main, Kenansville, NC 28349 | 2009-08-06 |
| 1679762066 | Mid-state Health Systems, Inc | Community/Behavioral Health | 117 Beasley St, 2nd Floor, Kenansville, NC 28349 | 2007-10-22 |
| 1861697310 | Teresa Ann Holland | Nurse Practitioner | 140 Limestone Rd, Kenansville, NC 28349 | 2007-06-15 |
| 1760521470 | Alpha Omega Health | Case Management | 103 East Hill Street, Suite 3, Kenansville, NC 28349 | 2007-02-06 |
| Find all providers in zip 28349 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702937 | Gha Autism Supports | Intermediate Care Facility, Mentally Retarded | 44012 Morrow Mountain Rd, Albemarle, NC 28001-8616 | 2020-05-21 |
| 1811517774 | Educare Community Living Corporation-north Carolina | Intermediate Care Facility, Mentally Retarded | 834 Tyvola Rd Ste 116, Charlotte, NC 28217-3542 | 2020-04-21 |
| 1598125460 | Rha Health Services Nc LLC | Intermediate Care Facility, Mentally Retarded | 410 N Mineral Springs Rd, Durham, NC 27703-3618 | 2016-03-04 |
| 1023478294 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 619 Ray Ave, Hendersonville, NC 28792-2668 | 2016-03-02 |
| 1740649417 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 310 Locust Street, West Jefferson, NC 28694 | 2016-02-23 |
| 1841655453 | Journeys Healthcare | Intermediate Care Facility, Mentally Retarded | 515 Carver Moore Rd, Lake Waccamaw, NC 28450-9713 | 2015-12-24 |
| 1326414665 | Rha North Carolina Mr, Inc. | Intermediate Care Facility, Mentally Retarded | 1388 Lewis Fork Baptist Ch Rd, Ferguson, NC 28624-9080 | 2015-08-20 |
| 1609299916 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2014-01-23 |
| 1861822314 | Voca Corporation of North Carolina | Intermediate Care Facility, Mentally Retarded | 4109 Enoch Dr, Charlotte, NC 28269-2578 | 2013-11-20 |
| 1902144314 | Rouse's Group Home Inc | Intermediate Care Facility, Mentally Retarded | 5820 Nc 135, Stoneville, NC 27048-8478 | 2013-01-18 |
| Find all providers with the same taxonomy | ||||
| City | KENANSVILLE |
| Zip Code | 28349 |
Please comment or provide details below to improve the information on SKILL CREATIONS OF KENANSVILLE.
| 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.