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Echo Trail Group Home

Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Pfafftown, NC

NPI 1457528788 · NPPES record last updated May 15, 2008

Key facts

NPI
1457528788
Entity type
Organization (NPI type 2)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 320800000X
Legal business name
ECHO TRAIL GROUP HOME
Practice address
1930 Echo TRL
Pfafftown, NC 27040-9518
Phone
(336) 924-6649
NPI assigned
May 15, 2008
Organization subpart
Yes
Parent organization (as reported)
NEW-LITE LIVING CHOICES, INC

Authorized official

Name
Stephanie Cahoon
Title
Billing Specialist
Phone
(704) 906-8893

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Goldenblush Circle Group Home (4 organizations share this tax ID)
Part of
Goldenblush Circle Group Home

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Yes

Addresses

Primary practice location

1930 Echo TRL
Pfafftown, NC 27040-9518

Mailing address

3634 Vest Mill Rd
Winston Salem, NC 27103-2910
Phone (704) 547-1900

Other identifiers

IdentifierTypeStateIssuer
6604265MedicaidNC

Other providers in Pfafftown, NC

All providers in Pfafftown, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.