Active NPI
Essentially Living Inc
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Kings Mountain, NC
National Provider Identifier
1689716102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- License
- MHL-023-092
- Legal business name
- ESSENTIALLY LIVING INC
- Practice address
- 301 S Battleground Ave
Kings Mountain, NC 28086-3601 - Phone
- (704) 739-3997
- Fax
- (704) 739-6420
- NPI assigned
- Feb 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Aaron Anderson
- Title
- Ceo
- Phone
- (704) 913-5779
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | MHL-023-092 | NC | Primary |
Addresses
Primary practice location
301 S Battleground Ave
Kings Mountain, NC 28086-3601
Mailing address
PO Box 1593
Kings Mountain, NC 28086-1593
Phone (704) 739-3997
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6604127 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Essentially Living Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Kings Mountain, NC
- NPI 1356534176
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Kings Mountain, NC
- NPI 1952596413
Locations
301 S Battleground Ave
Kings Mountain, NC 28086
Phone (704) 739-3997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1189468800000",
"number": "1689716102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1593",
"city": "KINGS MOUNTAIN",
"state": "NC",
"postal_code": "280861593",
"telephone_number": "704-739-3997",
"fax_number": "704-739-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S BATTLEGROUND AVE",
"city": "KINGS MOUNTAIN",
"state": "NC",
"postal_code": "280863601",
"telephone_number": "704-739-3997",
"fax_number": "704-739-6420"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ESSENTIALLY LIVING INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-12",
"last_updated": "2007-09-11",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "AARON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "704-913-5779",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "NC",
"license": "MHL-023-092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6604127",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kings Mountain, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.