Active NPI
Central Care Division, LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Eden, NC
National Provider Identifier
1346415809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- License
- MHL-079-088
- 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, 2010
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6604262 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Central Care Division LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Eden, NC
- NPI 1376692509
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
- Joe Gray Carpenter, PT, DPT,OCS, FAAOMPT
- Erin Jones Carroll, PA-C
- Kelsey Carter
- Angel G Cassell, HOME CARE AID
- Reginald Cathey, MD
- Central Care Division, LLC
- Central State of the Carolinas, Inc.
- Ashly Chadwell, DPT
- Challenges Group Homes, Inc (Connections Behavioral Health Services)
- Challenges Group Homes, Inc. (Connections Behavioral Health Services)
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.