Organization Active NPI

Triad Adult Day Care Center, Inc.

  • Developmentally Disabled Services Day Training Agency
  • High Point, NC
National Provider Identifier
1629108071
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
MHL-041-1084 Issued in NC
Legal business name
TRIAD ADULT DAY CARE CENTER, INC.
Practice address
409 E Fairfield Rd
Suite a
High Point, NC 27263-2281
Phone
(336) 431-1537
Fax
(336) 431-8128
NPI assigned
Mar 6, 2007
Last updated
Dec 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Ms. Lasonya Vaneaton, QP
Title
Director
Phone
(336) 431-1537

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MHL-041-1084 NC Primary
Adult Day Care Clinic/Center 261QA0600X MHL-041-1084 NC
Developmental Disabilities Clinic/Center 261QD1600X MHL-041-1084 NC
Assisted Living Facility (Mental Illness) 3104A0625X MHL-041-987 NC
Adult Care Home Facility 311ZA0620X MHL-041-987 NC
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-041-987 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-041-813 NC
Community/Behavioral Health Agency 251S00000X MHL-041-1084 NC

Addresses

Primary practice location

409 E Fairfield Rd
Suite a
High Point, NC 27263-2281

Mailing address

409 E Fairfield Rd
Suite a
High Point, NC 27263-2281
Phone (336) 431-1537

Other identifiers 1

IdentifierTypeStateIssuer
3408665MedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2095728Triad Adult Day Care Center, Inc409 E Fairfield Road, Suite a, High Point, NC 27263Certificate of waiverMay 10, 2027

National Provider Directory

National Provider Directory

Locations

409 E Fairfield Rd
Ste A
High Point, NC 27263
Phone (336) 431-1537

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1629108071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E FAIRFIELD RD",
            "address_2": "SUITE A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272632281",
            "telephone_number": "336-431-1537",
            "fax_number": "336-431-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E FAIRFIELD RD",
            "address_2": "SUITE A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272632281",
            "telephone_number": "336-431-1537",
            "fax_number": "336-431-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD ADULT DAY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "VANEATON",
        "authorized_official_first_name": "LASONYA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-431-1537",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "QP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL-041-1084",
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NC",
            "license": "MHL-041-1084",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NC",
            "license": "MHL-041-1084",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NC",
            "license": "MHL-041-987",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-041-987",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-041-987",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-041-813",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-041-1084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408665",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.