Passionate Care Group Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL 051144 Issued in NC

Legal business name

PASSIONATE CARE GROUP HOME

Practice address

105 Walnut Creek Drive
Clayton, NC 27520-7242

Phone

(919) 332-2171

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Chanta'E Altman

Title

Director of Operations/Cfo

Phone

(919) 332-2171

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1104940782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 HONEYSPOT RD",
            "address_2": "SUITE 200",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157172",
            "telephone_number": "203-378-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALNUT CREEK DRIVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275207242",
            "telephone_number": "919-332-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSIONATE CARE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "CHANTA'E",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS/CFO",
        "authorized_official_telephone_number": "919-332-2171"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL 051144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "7805103",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Clayton, NC
• Providers in Clayton, NC by specialty
• Mental Illness 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 Sep 25, 2023; 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.