Learning Village Academy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LEARNING VILLAGE ACADEMY LLC

Practice address

711 Sawyers Mill Rd Apt 307
Charlotte, NC 28262-1849

Phone

(843) 309-7293

NPI assigned

May 4, 2019

Organization subpart

No

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

Authorized official

Name

Tysheika Santoria Sims

Title

Owner

Phone

(843) 309-7293

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1556928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556928000000",
    "number": "1750946828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SAWYERS MILL RD APT 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621849",
            "telephone_number": "843-309-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SAWYERS MILL RD APT 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621849",
            "telephone_number": "843-309-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEARNING VILLAGE ACADEMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-04",
        "last_updated": "2019-05-04",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "TYSHEIKA",
        "authorized_official_middle_name": "SANTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-309-7293"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538567888",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2019; 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.