Shufford Group Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-092-709 Issued in NC

Legal business name

SHUFFORD GROUP HOME

Practice address

5164 Limewood St
Knightdale, NC 27545-8138

Phone

(919) 986-0053

Fax

(919) 231-0426

NPI assigned

Jun 3, 2008

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Annette Lashonda Shufford

Title

Owner

Phone

(919) 986-0053

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1639338825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 DEEDA CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5164 LIMEWOOD ST",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458138",
            "telephone_number": "919-986-0053",
            "fax_number": "919-231-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUFFORD GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SHUFFORD",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "LASHONDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-986-0053"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-092-709",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-092-709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabriya Laila Sharif-Hanifa, MS, LCAS-A
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• Calli Shaver, PT
• John M Shepard, PA-C
• Danyel Sherman, MED, BCBA
• Rachel Silver
• Simpson & Associates Counseling Services
• Brandi Simpson, BCBA
• Ruby Sims, LCMHC-A
• Chad Smith, PA

• Emotionally Disturbed Childrens' Residential Treatment Facility in Knightdale, NC
• Providers in Knightdale, 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 Jun 19, 2008; 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.