Magnanimous Group Home LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-052-016 Issued in NC

Legal business name

MAGNANIMOUS GROUP HOME LLC

Practice address

9407 Hwy 41 W
Pink Hill, NC 28572-7021

Phone

(910) 324-3276

NPI assigned

Aug 6, 2009

Last updated

Aug 6, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Isaiah Johnson

Title

Ceo

Phone

(910) 382-9985

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1003047069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 HWY 41 W",
            "city": "PINK HILL",
            "state": "NC",
            "postal_code": "285727021",
            "telephone_number": "910-324-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 HWY 41 W",
            "city": "PINK HILL",
            "state": "NC",
            "postal_code": "285727021",
            "telephone_number": "910-324-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNANIMOUS GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ISAIAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-382-9985"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-052-016",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Jackson
• Rhonda Mizelle Jones, PT
• Cynthia Robinson King, RPH
• Lenoir Assisted Living LLC
• Edwin P Little, MD
• Jennifer Trachte Murphy, DC, DICCP
• North Carolina Recovery Network
• Pink Hill Chiropractic, PA
• Pink Hill Pharmacy Inc
• Realo Discount Drug Stores of Pink Hill, Inc.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Pink Hill, NC
• Providers in Pink Hill, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.