New River Cottage, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

MHL003003 Issued in NC

Legal business name

NEW RIVER COTTAGE, INC.

Practice address

82 Davis Lane
Sparta, NC 28675-0488

Phone

(336) 372-5671

Fax

(336) 372-5672

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Darlene Douglas, MS

Title

Executive Director

Phone

(336) 372-5671

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619984283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "address_2": "82 DAVIS LANE",
            "city": "SPARTA",
            "state": "NC",
            "postal_code": "286750488",
            "telephone_number": "336-372-5671",
            "fax_number": "336-372-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 DAVIS LANE",
            "city": "SPARTA",
            "state": "NC",
            "postal_code": "286750488",
            "telephone_number": "336-372-5671",
            "fax_number": "336-372-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER COTTAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-372-5671",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL003003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MHL003003",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen L McNeil, MD
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• New River Mental Health Center
• New River Service Authority
• Northland Hearing Center, Inc.
• Oliver Optometric Eye Care

• All providers in Sparta, NC
• Intellectual Disabilities Intermediate Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.