NPIMap

Organization Active NPI

New Abundant Living 3

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Eden, NC
National Provider Identifier
1104090562
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
NEW ABUNDANT LIVING 3
Practice address
1014 West Ave
Eden, NC 27288-6430
Phone
(336) 623-7669
NPI assigned
Apr 16, 2008
Organization subpart
Yes
Parent organization
ABUNDANT LIVING GROUP HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Janice Timpson
Title
Owner
Phone
(336) 623-7669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NC Primary

Addresses

Primary practice location

1014 West Ave
Eden, NC 27288-6430

Mailing address

438 Creekridge Dr
Eden, NC 27288-2817
Phone (336) 623-7669

National Provider Directory

National Provider Directory
Tax ID family
New Abundant Living 33 organizations share this tax ID, including this one
Part of
New Abundant Living 3

Other organizations with this tax ID 2

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": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1104090562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 CREEKRIDGE DR",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272882817",
            "telephone_number": "336-623-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WEST AVE",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272886430",
            "telephone_number": "336-623-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ABUNDANT LIVING 3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABUNDANT LIVING GROUP HOME",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "TIMPSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-623-7669"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.