NPIMap

Organization Active NPI

Southeastern Adult Day Center

  • Mental Illness Community Based Residential Treatment Facility
  • Benson, NC
National Provider Identifier
1093997876
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL051163 Issued in NC
Legal business name
SOUTHEASTERN ADULT DAY CENTER
Practice address
144 Peach Orchard Dr
Benson, NC 27504-8304
Phone
(919) 894-7870
NPI assigned
Dec 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Evelyn Sanders, LCSWNPI 1578660130
Title
Executive Director
Phone
(919) 894-5399

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL051163 NC Primary

Addresses

Primary practice location

144 Peach Orchard Dr
Benson, NC 27504-8304

Mailing address

144 Peach Orchard Dr
Benson, NC 27504-8304
Phone (919) 894-7870

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Adult Day Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1093997876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 PEACH ORCHARD DR",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048304",
            "telephone_number": "919-894-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 PEACH ORCHARD DR",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048304",
            "telephone_number": "919-894-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ADULT DAY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-894-5399",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL051163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.