Organization Active NPI

Central Care Division, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Eden, NC
National Provider Identifier
1346415809
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MHL-079-088 Issued in NC
Legal business name
CENTRAL CARE DIVISION, LLC
Practice address
907 Williams St
Eden, NC 27288-5515
Phone
(336) 635-2000
Fax
(336) 635-2003
NPI assigned
Apr 25, 2008
Last updated
Sep 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Edward F. Staples
Title
Owner
Phone
(336) 635-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-079-088 NC Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NC

Addresses

Primary practice location

907 Williams St
Eden, NC 27288-5515

Mailing address

405 N. Bridge St
Eden, NC 27288-5647
Phone (336) 635-2000

Other identifiers 1

IdentifierTypeStateIssuer
6604262MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Central Care Division LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

405 N Bridge St
Eden, NC 27288

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1346415809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N. BRIDGE ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885647",
            "telephone_number": "336-635-2000",
            "fax_number": "336-635-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 WILLIAMS ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885515",
            "telephone_number": "336-635-2000",
            "fax_number": "336-635-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CARE DIVISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "STAPLES",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-635-2000"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-079-088",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604262",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.