NPIMap

Organization Active NPI

Deshall'S Garden of Life, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1013437540
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DESHALL'S GARDEN OF LIFE, LLC
Practice address
415 Berkley Hill Drive
Apt 1314
Charlotte, NC 28262
Phone
(845) 728-6166
NPI assigned
Jun 26, 2017
Organization subpart
Yes
Parent organization
DESHALL'S GARDEN OF LIFE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Deshall Monique HillNPI 1669770392
Title
Owner
Phone
(845) 728-9166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NC
Assisted Living Facility 310400000X NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NC
Mental Illness Community Based Residential Treatment Facility 320800000X NC Primary

Addresses

Primary practice location

415 Berkley Hill Drive
Apt 1314
Charlotte, NC 28262

Mailing address

415 Berkley Hill Dr.
#1314
Charlotte, NC 28262-9720
Phone (845) 728-6166

National Provider Directory

National Provider Directory
Part of
Deshall'S Garden of Life LLC

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013437540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BERKLEY HILL DR.",
            "address_2": "#1314",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629720",
            "telephone_number": "845-728-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BERKLEY HILL DRIVE",
            "address_2": "APT 1314",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28262",
            "telephone_number": "845-728-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESHALL'S GARDEN OF LIFE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESHALL'S GARDEN OF LIFE, LLC",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DESHALL",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-728-9166",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.