Coltranes Group Home

Primary specialty

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

License

MHL-041-620 Issued in NC

Legal business name

COLTRANES GROUP HOME

Practice address

3811 Repon St
Greensboro, NC 27407-5536

Phone

(336) 299-9757

Fax

(336) 299-1419

NPI assigned

Sep 11, 2007

Organization subpart

Yes

Parent organization

COLTRANES GROUP HOMEAs reported in NPPES

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

Authorized official

Name

Ms. Lathay Lorraine Coltrane

Title

Owner/Operator

Phone

(336) 299-9757

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Coltranes Group Home3 organizations share this tax ID, including this one

Part of

Coltranes Group Home

Other organizations with this tax ID 2

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

• Coltrane's Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1437324902
  NPD tax ID
• Coltranes Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1366594715
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Coltranes Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1366594715
  NPPES parent name

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1750576997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79113",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274179113",
            "telephone_number": "336-299-9757",
            "fax_number": "336-299-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 REPON ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075536",
            "telephone_number": "336-299-9757",
            "fax_number": "336-299-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTRANES GROUP HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLTRANES GROUP HOME",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "COLTRANE",
        "authorized_official_first_name": "LATHAY",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "336-299-9757",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-041-620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804354",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408773",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colten Butler DMD PLLC (Haw River Dental)
• Lathay Coltrane
• Teresa L Coltrane, RN
• Coltrane's Group Home
• Coltranes Group Home
• Rachel Morgan Colvin
• Allison Brooke Combs, D.O.
• Kelsy Edward Combs, PHARMD
• Kristen Combs
• Comeau Physical Therapy LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Greensboro, NC
• Providers in Greensboro, 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 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.

Verify at the official NPI Registry.