Active NPI
New Generation Church/Community Dev. Corp
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Clayton, NC
National Provider Identifier
1497896138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- License
- MHL-051-129
- Legal business name
- NEW GENERATION CHURCH/COMMUNITY DEV. CORP
- Practice address
- 548 Jack Rd
Clayton, NC 27520-6121 - Phone
- (919) 553-9251
- NPI assigned
- Feb 8, 2007
- 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
- Ms. Sheila Evans
- Title
- Administrator
- Phone
- (919) 553-9251
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | MHL-051-129 | NC | Primary |
Addresses
Primary practice location
548 Jack Rd
Clayton, NC 27520-6121
Mailing address
PO Box 328
Zebulon, NC 27597-0328
Phone (919) 553-9251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7804766 | Medicaid | NC |
Other names 1
- TENDER LOVE INDEPENDENT HOME CARE
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214956800000",
"number": "1497896138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 328",
"city": "ZEBULON",
"state": "NC",
"postal_code": "275970328",
"telephone_number": "919-553-9251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "548 JACK RD",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275206121",
"telephone_number": "919-553-9251"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW GENERATION CHURCH/COMMUNITY DEV. CORP",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-08",
"last_updated": "2008-07-02",
"status": "A",
"authorized_official_last_name": "EVANS",
"authorized_official_first_name": "SHEILA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "919-553-9251",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NC",
"license": "MHL-051-129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7804766",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "TENDER LOVE INDEPENDENT HOME CARE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.