NPIMap

Organization Active NPI

Self Determination, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Lenoir, NC
National Provider Identifier
1568852424
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
014082 Issued in NC
Legal business name
SELF DETERMINATION, LLC
Practice address
1023 Bramblewood CT NE
Lenoir, NC 28645-3835
Phone
(828) 754-1889
NPI assigned
Jan 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Anne Jeffries
Title
Owner
Phone
(828) 754-1889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 014082 NC Primary

Addresses

Primary practice location

1023 Bramblewood CT NE
Lenoir, NC 28645-3835

Mailing address

1023 Bramblewood CT NE
Lenoir, NC 28645-3835
Phone (828) 754-1889

National Provider Directory

National Provider Directory
Tax ID family
Self Determination LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1568852424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 BRAMBLEWOOD CT NE",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286453835",
            "telephone_number": "828-754-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 BRAMBLEWOOD CT NE",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286453835",
            "telephone_number": "828-754-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF DETERMINATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-754-1889"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "014082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.