Edell's Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

322D00000X Issued in NC

Legal business name

EDELL'S INC.

Practice address

1015 Plymouth Dr
New Bern, NC 28562-2537

Phone

(252) 636-1419

Fax

(252) 672-5653

NPI assigned

Feb 6, 2007

Last updated

Aug 22, 2020By 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

Mrs. Carolyn Delores Williams

Title

Executive Director

Phone

(252) 636-1419

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073652749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 PLYMOUTH DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622537",
            "telephone_number": "252-636-1419",
            "fax_number": "252-672-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 PLYMOUTH DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622537",
            "telephone_number": "252-636-1419",
            "fax_number": "252-672-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDELL'S INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "DELORES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-636-1419",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "322D00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY NUMBER",
            "identifier": "322D00000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.