Heartwood Family Care
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Browns Summit, NC
NPI 1710121603 · NPPES record last updated Apr 23, 2009
Key facts
- NPI
- 1710121603
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- License
- MHL-041-152 (NC)
- Legal business name
- HEARTWOOD FAMILY CARE
- Practice address
- 5921 Bush Rd
Browns Summit, NC 27214-9612 - Phone
- (336) 358-9287
- Fax
- (336) 273-6522
- NPI assigned
- Apr 23, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- ALBERTA PROFESSIONAL SERVICES, INC.
Authorized official
- Name
- Mr. Derek Mitchell, BS, QP
- Title
- Operations Manager
- Phone
- (336) 273-2640
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Taylor Home
- Part of
- Taylor Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | MHL-041-152 | NC | Yes |
Addresses
Primary practice location
5921 Bush Rd
Browns Summit, NC 27214-9612
Mailing address
1000 Revolution Mill Dr
Studio #2
Greensboro, NC 27405-5082
Phone (336) 273-2640
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6603003 | Medicaid | NC |
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- Jeremy Hinton
- Amber Stroupe Howard
- Imatter Counseling Services, PLLC
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All providers in Browns Summit, NC · Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.