Making a Difference Grouphome

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

MHL033090 Issued in NC

Legal business name

MAKING A DIFFERENCE GROUPHOME

Practice address

1820 Bedford Rd
Rocky Mount, NC 27801-6303

Phone

(252) 469-5264

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Willie Morris Jr., BS,QP

Title

Administrator

Phone

(252) 469-5264

Specialties & licenses 1

Addresses

Other names 1

• Making A Difference GroupHome Former legal business name

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1093017238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 BEDFORD RD",
            "address_2": "1820 BEDFORD ROAD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278016303",
            "telephone_number": "252-469-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 BEDFORD RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278016303",
            "telephone_number": "252-469-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKING A DIFFERENCE GROUPHOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-469-5264",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "BS,QP"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL033090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Making A Difference GroupHome",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gloria Jean Mabry
• Nitaya Reyes Mackey, IBCLC
• Glenn Edward Macnichol, M.D.
• Macta, LLC
• Evelyn Rudo Majachani, PMHNP
• Marcy Maksail, MA
• Melissa Malinowski, RN, BSN, MSN, NP-C
• Arun Manikumar
• Stephanie Brown Mann, CRNA
• Kathy Lynn Manning, M.S., CCC-SLP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Intellectual and/or Developmental Disabilities 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 Nov 19, 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.