NPIMap

Organization Active NPI

Sedalia Center #2

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Gibsonville, NC
National Provider Identifier
1063624641
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
FCL-041-070 Issued in NC
Legal business name
SEDALIA CENTER #2
Practice address
6143 Blue Lantern Rd
Gibsonville, NC 27249-8737
Phone
(336) 275-7328
Fax
(336) 272-6359
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Authorized official

Name
Ms. Glenda T Liggins
Title
Owner
Phone
(336) 275-7328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X FCL-041-070 NC Primary

Addresses

Primary practice location

6143 Blue Lantern Rd
Gibsonville, NC 27249-8737

Mailing address

6143 Blue Lantern Rd
Gibsonville, NC 27249-8737
Phone (336) 275-7328

Other identifiers 1

IdentifierTypeStateIssuer
FCL-041-070MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sedalia Center 17 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1063624641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 BLUE LANTERN RD",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272498737",
            "telephone_number": "336-275-7328",
            "fax_number": "336-272-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 BLUE LANTERN RD",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272498737",
            "telephone_number": "336-275-7328",
            "fax_number": "336-272-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDALIA CENTER #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "LIGGINS",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-275-7328",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "FCL-041-070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FCL-041-070",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.