Sylvanglade Home, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

MHL041572 Issued in NC

Legal business name

SYLVANGLADE HOME, INC.

Doing business as

Donnell Group Home

Practice address

4915 Sylvanglade Rd
MC Leansville, NC 27301-9753

Phone

(336) 358-2156

NPI assigned

Jun 19, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Hattie Cheeks Graves

Title

Ceo

Phone

(336) 621-8119

Specialties & licenses 1

Addresses

Other names 1

• Donnell Group Home Doing business as

Tax ID family

Donnell Group Home2 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.

• Sylvanglade Home, Inc.

  • Assisted Living Facility (Mental Illness)
  • MC Leansville, NC
  • NPI 1497844302
  NPD tax ID

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1629273610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 SYLVANGLADE RD",
            "city": "MC LEANSVILLE",
            "state": "NC",
            "postal_code": "273019753",
            "telephone_number": "336-358-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 SYLVANGLADE RD",
            "city": "MC LEANSVILLE",
            "state": "NC",
            "postal_code": "273019753",
            "telephone_number": "336-358-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLVANGLADE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "HATTIE",
        "authorized_official_middle_name": "CHEEKS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-621-8119",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL041572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donnell Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Sellers
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• Ava Laverne Stevenson, MA, LACS-A
• Sylvanglade Home, Inc.
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• The Moses H Cone Memorial Hospital Operating Corporation
• The Turning Pointe Healthcare Services, LLC
• TLC Support & Habitation
• True Connection Therapy

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in MC Leansville, NC
• Providers in MC Leansville, NC by specialty
• Intellectual and/or Developmental Disabilities 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 Aug 29, 2011; 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.