NPIMap

Organization Active NPI

Homestead Place

  • Psychiatric Residential Treatment Facility
  • Chapel Hill, NC
National Provider Identifier
1740424639
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
MHL-068-139 Issued in NC
Legal business name
HOMESTEAD PLACE
Practice address
2032 Homestead Place
Chapel Hill, NC 27516-9076
Phone
(919) 240-5016
Fax
(336) 273-6522
NPI assigned
Apr 23, 2009
Organization subpart
Yes
Parent organization
ALBERTA PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Mr. Derek Mitchell, BS, QP
Title
Operations Manager
Phone
(336) 273-2640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X MHL-068-139 NC Primary

Addresses

Primary practice location

2032 Homestead Place
Chapel Hill, NC 27516-9076

Mailing address

3107 S Elm Eugene St
Building a
Greensboro, NC 27406-5201
Phone (336) 273-2640

Other identifiers 1

IdentifierTypeStateIssuer
7806104MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Taylor Home15 organizations share this tax ID, including this one
Part of
Taylor Home

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1740424639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 S ELM EUGENE ST",
            "address_2": "BUILDING A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065201",
            "telephone_number": "336-273-2640",
            "fax_number": "336-273-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 HOMESTEAD PLACE",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275169076",
            "telephone_number": "919-240-5016",
            "fax_number": "336-273-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD PLACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALBERTA PROFESSIONAL SERVICES",
        "enumeration_date": "2009-04-23",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "336-273-2640",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, QP"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NC",
            "license": "MHL-068-139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7806104",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.