North Carolina Children'S Place, Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-090-135 Issued in NC

Legal business name

NORTH CAROLINA CHILDREN'S PLACE, INC

Practice address

504 Sunnybrook Dr
Monroe, NC 28110-2719

Phone

(336) 449-9775

NPI assigned

Nov 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Alicia Y Clodfelter

Title

Vice President

Phone

(336) 449-9775

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

North Carolina Children'S Place Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• North Carolina Children'S Place, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Winston Salem, NC
  • NPI 1932389475
  NPD tax ID

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1619157153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 GREYROCK RD",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "273779225",
            "telephone_number": "336-449-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SUNNYBROOK DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102719",
            "telephone_number": "336-449-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA CHILDREN'S PLACE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "CLODFELTER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-449-9775",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-090-135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603342",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cam Tieu Ngo, OD
• Nigatu D.D.S. Monroe P.C.
• Erin Nixon
• Hailey Normandin, OTR/L
• Norris Medical PLLC
• North Carolina CVS Pharmacy LLC
• North Carolina CVS Pharmacy LLC
• North Carolina CVS Pharmacy LLC
• North Carolina CVS Pharmacy LLC
• Northland Hearing Centers, Inc.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Monroe, NC
• Providers in Monroe, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.