Coltranes Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

COLTRANES GROUP HOME

Practice address

3811 Repon St
Greensboro, NC 27407-5536

Phone

(336) 299-9757

Fax

(336) 299-1419

NPI assigned

Jan 17, 2007

Last updated

Apr 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lathay Lorraine ColtraneNPI 1801567763

Title

Owner

Phone

(336) 299-9757

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Coltranes Group Home Inc Former legal business name

Tax ID family

Coltranes Group Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Coltrane's Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1437324902
  NPD tax ID
• Coltranes Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1750576997
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Coltranes Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1750576997
  NPPES parent name

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.

• Lathay Coltrane

  • Adult Day Care Clinic/Center
  • Greensboro, NC
  • NPI 1801567763
  Authorized official Same address or phone

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1366594715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 REPON ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075536",
            "telephone_number": "336-299-9757",
            "fax_number": "336-299-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 REPON ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075536",
            "telephone_number": "336-299-9757",
            "fax_number": "336-299-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTRANES GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "COLTRANE",
        "authorized_official_first_name": "LATHAY",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-299-9757",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804354",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408773",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coltranes Group Home Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kabrya Elizabeth Colson
• Colten Butler DMD PLLC (Haw River Dental)
• Lathay Coltrane
• Teresa L Coltrane, RN
• Coltrane's Group Home
• Coltranes Group Home
• Rachel Morgan Colvin
• Allison Brooke Combs, D.O.
• Kelsy Edward Combs, PHARMD
• Kristen Combs

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Intellectual and/or Developmental Disabilities 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 Apr 25, 2008; 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.