Wooded Acres #3

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL007055 Issued in NC

Legal business name

WOODED ACRES #3

Practice address

3680 Cherry Rd
Washington, NC 27889-7267

Phone

(252) 946-5997

Fax

(252) 946-6245

NPI assigned

May 24, 2007

Organization subpart

Yes

Parent organization

WOODED ACRES GUEST HOME, INC.As reported in NPPES

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

Addresses

Other identifiers 1

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.

• Wooded Acres #1

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Washington, NC
  • NPI 1447433479
  NPD tax ID
• Wooded Acres #4

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Washington, NC
  • NPI 1437350048
  NPD tax ID
• Wooded Acres Guest Home #1

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Washington, NC
  • NPI 1275744963
  NPD tax ID
• Wooded Acres Guest Home #2

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Washington, NC
  • NPI 1629279237
  NPD tax ID

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1609087303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 CHERRY RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278897267",
            "telephone_number": "252-946-5997",
            "fax_number": "252-946-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 CHERRY RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278897267",
            "telephone_number": "252-946-5997",
            "fax_number": "252-946-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODED ACRES #3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODED ACRES GUEST HOME, INC.",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-11-15",
        "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": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL007055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805860",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Williams
• Sharice La'Shae Williams, LCSW-A
• Brooke Wingate, COTA/L
• Katherine Diane Wood, LCAS-A
• Wooded Acres #1
• Wooded Acres #4
• Wooded Acres #5
• Wooded Acres #6
• Wooded Acres Guest Home #1
• Wooded Acres Guest Home #2

• Mental Illness Community Based Residential Treatment Facility in Washington, NC
• Providers in Washington, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.