Piedmont Pioneer House, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL-036-004 Issued in NC

Legal business name

PIEDMONT PIONEER HOUSE, INC.

Practice address

910 Roberts Dr
Gastonia, NC 28054-5804

Phone

(704) 866-8751

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Vonda Kaye Burton, QMHP, QDDP

Title

Executive Director

Phone

(704) 884-2701

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295939411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 ROBERTS DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545804",
            "telephone_number": "704-866-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 ROBERTS DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545804",
            "telephone_number": "704-866-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT PIONEER HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "VONDA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-884-2701",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "QMHP, QDDP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-036-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301292S",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Piedmont Pharmacy LLC
• Piedmont Pioneer House, Inc.
• Piedmont Plastic Surgery & Dermatology PA
• Piedmont Speech, Language, and Learning
• Piedmont Urology Associates PA
• Breyunna Jalyn Pierce, RN

• Mental Illness Community Based Residential Treatment Facility in Gastonia, NC
• Providers in Gastonia, 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 Aug 22, 2020; 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.