NPIMap

Organization Active NPI

Timber Ridge Treatment Center, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Gold Hill, NC
National Provider Identifier
1609852201
Registry record updated Jan 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-080-035 Issued in NC
Legal business name
TIMBER RIDGE TREATMENT CENTER, INC.
Practice address
665 Timber Trail
Gold Hill, NC 28071
Phone
(704) 279-1199
Fax
(704) 279-7668
NPI assigned
Dec 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2021

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

Authorized official

Name
Laurie Dodge Hibbert, MED.
Title
V. President
Phone
(704) 279-1199

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-080-035 NC Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-080-035 NC
Psychiatric Residential Treatment Facility 323P00000X MHL-080-035 NC

Addresses

Primary practice location

665 Timber Trail
Gold Hill, NC 28071

Mailing address

P O Box 259
665 Timber Trail
Gold Hill, NC 28071-7661
Phone (704) 279-1199

Other identifiers 2

IdentifierTypeStateIssuer
001FYOtherNCBCBS
6603028MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609632000000",
    "number": "1609852201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 259",
            "address_2": "665 TIMBER TRAIL",
            "city": "GOLD HILL",
            "state": "NC",
            "postal_code": "280717661",
            "telephone_number": "704-279-1199",
            "fax_number": "704-279-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 TIMBER TRAIL",
            "city": "GOLD HILL",
            "state": "NC",
            "postal_code": "28071",
            "telephone_number": "704-279-1199",
            "fax_number": "704-279-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBER RIDGE TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2021-01-03",
        "certification_date": "2021-01-03",
        "status": "A",
        "authorized_official_last_name": "HIBBERT",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "DODGE",
        "authorized_official_title_or_position": "V. PRESIDENT",
        "authorized_official_telephone_number": "704-279-1199",
        "authorized_official_credential": "MED."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-080-035",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-080-035",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NC",
            "license": "MHL-080-035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001FY",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2021; 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.