Jada's House,LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-074-187 Issued in NC

Legal business name

JADA'S HOUSE,LLC

Practice address

3987 Sterling Pointe Dr
LLL-1
Winterville, NC 28590-9243

Phone

(252) 830-3934

NPI assigned

Nov 26, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole TaftNPI 1386824829

Title

Director

Phone

(252) 412-0797

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Taft

  • Mental Health Counselor
  • Winterville, NC
  • NPI 1386824829
  NPD (past) Authorized official

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1255512877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2193",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278360193",
            "telephone_number": "252-412-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3987 STERLING POINTE DR",
            "address_2": "LLL-1",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909243",
            "telephone_number": "252-830-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADA'S HOUSE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "TAFT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-412-0797",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-074-187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Winterville, NC
• Providers in Winterville, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.