Active NPI
Garden of Life, Inc
- Case Manager/Care Coordinator
- Charlotte, NC
National Provider Identifier
1477174407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Legal business name
- GARDEN OF LIFE, INC
- Practice address
- 8339 Fox Swamp Rd
Charlotte, NC 28215-9011 - Phone
- (980) 309-6863
- NPI assigned
- Apr 30, 2020
- 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
- Deshall Hill
- Title
- Owner
- Phone
- (890) 309-6863
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X |
Addresses
Primary practice location
8339 Fox Swamp Rd
Charlotte, NC 28215-9011
Mailing address
8339 Fox Swamp Rd
Charlotte, NC 28215-9011
Phone (845) 728-9166
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171M00000X | Medicaid | NC | |
| 225I0000X | Medicaid | NC | |
| 251S00000X | Medicaid | NC | |
| 106S0000X | Medicaid | NC | |
| 251B00000X | Medicaid | NC | |
| 302R0000X | Medicaid | NC | |
| 1041I0000X | Medicaid | NC | |
| 22420000X | Medicaid | NC | |
| 2260000X | Medicaid | NC | |
| 305R0000X | Medicaid | NC | |
| 363L0000X | Medicaid | NC | |
| 302F0000X | Medicaid | NC | |
| 106H0000X | Medicaid | NC | |
| 175T0000X | Medicaid | NC | |
| 164W0000X | Medicaid | NC |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Charlotte, NC
- NPI 1669770392
Case Manager/Care Coordinator
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1597276800000",
"number": "1477174407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8339 FOX SWAMP RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282159011",
"telephone_number": "845-728-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8339 FOX SWAMP RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282159011",
"telephone_number": "980-309-6863"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARDEN OF LIFE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-30",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A",
"authorized_official_last_name": "HILL",
"authorized_official_first_name": "DESHALL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "890-309-6863"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171M00000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "225I0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251S00000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106S0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251B00000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302R0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1041I0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22420000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2260000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "305R0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363L0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302F0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106H0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "175T0000X",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164W0000X",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.