Bynum's Place LLC

Primary specialty

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

License

MHL091077 Issued in NC

Legal business name

BYNUM'S PLACE LLC

Doing business as

Jeremiah's Place

Practice address

1455 Bullocksville Road
Manson, NC 27553-9765

Phone

(252) 456-6534

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Moore Bynum

Title

Owner

Phone

(252) 915-9174

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeremiah's Place Doing business as

Tax ID family

Bynum's Place LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Bynum's Place LLC

  dba Michael's Place

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Manson, NC
  • NPI 1588706667
  NPD tax ID
• Bynum's Place LLC

  dba Bynum's Place

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Norlina, NC
  • NPI 1922140888
  NPD tax ID
• Bynum's Place, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Norlina, NC
  • NPI 1154463685
  NPD tax ID

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437292364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 BULLOCKSVILLE ROAD",
            "city": "MANSON",
            "state": "NC",
            "postal_code": "275539765",
            "telephone_number": "252-456-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 BULLOCKSVILLE ROAD",
            "city": "MANSON",
            "state": "NC",
            "postal_code": "275539765",
            "telephone_number": "252-456-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYNUM'S PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "MOORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-915-9174"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL091077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "041247",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeremiah's Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A Kind Ride, LLC
• Shekitta Lavett Acker, PA-C
• Maria Alvarez, DDS
• Bullock Care Transport & Family LLC
• Leslie Burchette
• Bynum's Place LLC (Michael's Place)
• Latisha Evans Cash
• Allison Elizabeth Cotten, LCSW, LCAS, CSI
• Philip James Hinman, LCSW
• Linda Means, MS

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Manson, NC
• Providers in Manson, 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 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.