Timothy Deans House LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL042063 Issued in NC

Legal business name

TIMOTHY DEANS HOUSE LLC

Practice address

337 Rapids St
Roanoke Rapids, NC 27870-1520

Phone

(252) 541-1556

Fax

(252) 541-1570

NPI assigned

Jan 5, 2012

Last updated

Jan 5, 2012By 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

F. Dean Vandyke

Title

Director

Phone

(252) 541-1556

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1790055812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 RAPIDS ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278701520",
            "telephone_number": "252-541-1556",
            "fax_number": "252-541-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 RAPIDS ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278701520",
            "telephone_number": "252-541-1556",
            "fax_number": "252-541-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY DEANS HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "VANDYKE",
        "authorized_official_first_name": "F.",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-541-1556"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL042063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Roanoke Rapids, NC
• Providers in Roanoke Rapids, 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 Jan 5, 2012; 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.