NPIMap

Organization Active NPI

Educare Community Living Corporation - North Carolina

  • Intellectual Disabilities Intermediate Care Facility
  • Winston Salem, NC
National Provider Identifier
1215057468
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
EDUCARE COMMUNITY LIVING CORPORATION - NORTH CAROLINA
Practice address
2901 Konnoak Dr
Winston Salem, NC 27127-3945
Phone
(336) 788-5543
NPI assigned
Mar 30, 2007
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
Chief Regulatory Officer Sr Asst GC
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

2901 Konnoak Dr
Winston Salem, NC 27127-3945

Mailing address

6600 France Ave S Ste 350
Edina, MN 55435-1810
Phone (800) 388-5150

Other names 1

  • EC GBO Konnoak Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Alternatives North Carolina39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1215057468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "800-388-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 KONNOAK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273945",
            "telephone_number": "336-788-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCARE COMMUNITY LIVING CORPORATION - NORTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER SR ASST GC",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EC GBO Konnoak",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.