Dynamic Care Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-026-558 Issued in NC

Legal business name

DYNAMIC CARE HOME

Practice address

739 Amber Dr
Fayetteville, NC 28311-1886

Phone

(910) 483-6416

Fax

(910) 483-5924

NPI assigned

May 3, 2007

Last updated

Dec 27, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

PRESTIGE INCAs reported in NPPES

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

Authorized official

Name

Ms. Shearldena M Turner

Title

Director

Phone

(910) 483-6416

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Open Arms Home3 organizations share this tax ID, including this one

Part of

Open Arms Home

Other organizations with this tax ID 2

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

• Open Arms Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fayetteville, NC
  • NPI 1780897843
  NPD tax ID
• Prestige Inc,

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1619156395
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prestige Inc,

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1619156395
  NPPES parent name

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1275755639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283020504",
            "telephone_number": "910-483-6416",
            "fax_number": "910-483-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 AMBER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111886",
            "telephone_number": "910-483-6416",
            "fax_number": "910-483-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CARE HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESTIGE INC",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "SHEARLDENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-483-6416",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-026-558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603198",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Maree Duso, DPT
• Jui Dutta
• Sarah Kristine Dvorak, CCNS, ARNP
• Ghanshyam Pradyumna Dwivedi, MD
• Ashley Dawn Marie Dykens, BCABA
• Dynamic Connections PLLC
• Dynamics of Care Services LLC
• Steven J Dzama, PA-C
• Vivian Dzokoto, PHD
• E. Gram Solutions, Inc

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.