NPIMap

Organization Active NPI

Wooded Acres #1

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Washington, NC
National Provider Identifier
1447433479
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL-007-053 Issued in NC
Legal business name
WOODED ACRES #1
Practice address
3706 Cherry Rd
Washington, NC 27889-7268
Phone
(252) 946-6245
Fax
(252) 946-6245
NPI assigned
Dec 13, 2007
Organization subpart
Yes
Parent organization
WOODED ACRES GUEST HOME, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Mr. James E Hardison Jr.
Title
Owner
Phone
(252) 946-6245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-007-053 NC Primary

Addresses

Primary practice location

3706 Cherry Rd
Washington, NC 27889-7268

Mailing address

3706 Cherry Rd
Washington, NC 27889-7268
Phone (252) 946-6245

Other identifiers 1

IdentifierTypeStateIssuer
7805958MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Wooded Acres 15 organizations share this tax ID, including this one
Part of
Wooded Acres 6

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1447433479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 CHERRY RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278897268",
            "telephone_number": "252-946-6245",
            "fax_number": "252-946-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 CHERRY RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278897268",
            "telephone_number": "252-946-6245",
            "fax_number": "252-946-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODED ACRES #1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODED ACRES GUEST HOME, INC.",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "HARDISON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-946-6245",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-007-053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805958",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.