Cedar Grove Group Homes, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

8300945 Issued in NC

Legal business name

CEDAR GROVE GROUP HOMES, INC.

Practice address

140 Country Run LN
Goldsboro, NC 27530-8901

Phone

(919) 738-1765

Fax

(919) 751-0089

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Wanda Williams Jones, MHSA

Title

Director

Phone

(919) 738-1765

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063567188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1343",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275331343",
            "telephone_number": "919-738-1765",
            "fax_number": "919-751-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COUNTRY RUN LN",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275308901",
            "telephone_number": "919-738-1765",
            "fax_number": "919-751-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR GROVE GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-738-1765",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "8300945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418140",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805605",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804842",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300945",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Charmaine Cates, LCAS
• Catholic Charities of the Diocese of Raleigh, Inc.
• Katie Lynn Catton, LCSW
• Amanda Kate Cauley-Harvey, FNP-BC
• Stephen G. Cecil, MD
• Celestine I. Amaefule, M.D. PC
• Center for Aesthetic Plastic Surgery, PLLC
• Carmen Cestaro, DNP, RN, FNP-BC
• Jane Chadwick, D.D.S.
• James Chamberlain, PHARMD

• Mental Illness Community Based Residential Treatment Facility in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.