The Mental Health Association in North Carolina, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL-049-062 Issued in NC

Legal business name

THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.

Doing business as

Brookdale

Practice address

711 Brookdale Dr
Statesville, NC 28677-3405

Phone

(704) 872-5540

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Cochran

Title

Financial Assistant

Phone

(919) 866-3287

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookdale Doing business as

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780807735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276075166",
            "telephone_number": "919-866-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773405",
            "telephone_number": "704-872-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "FINANCIAL ASSISTANT",
        "authorized_official_telephone_number": "919-866-3287",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-049-062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803432",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vienna Thao
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• Robert E Theiss, MD
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• Thomas E. McDaniel, LCSW Inc.
• Thomas Hand & Rehab Specialists Limited Partnership

• Mental Illness Community Based Residential Treatment Facility in Statesville, NC
• Providers in Statesville, NC by specialty
• Mental Illness 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 Aug 22, 2020; 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.