NPIMap

Organization Active NPI

Sedalia Center #1

  • Mental Illness Community Based Residential Treatment Facility
  • Gibsonville, NC
National Provider Identifier
1790997542
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-041-779 Issued in NC
Legal business name
SEDALIA CENTER #1
Practice address
6141 Blue Lantern Rd
Gibsonville, NC 27249-8737
Phone
(336) 275-7328
Fax
(336) 272-6359
NPI assigned
May 4, 2007
Organization subpart
Yes
Parent organization
LIGGINS FAMILY CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Ms. Glenda T Liggins
Title
Owner
Phone
(336) 275-7328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-041-779 NC Primary

Addresses

Primary practice location

6141 Blue Lantern Rd
Gibsonville, NC 27249-8737

Mailing address

6141 Blue Lantern Rd
Gibsonville, NC 27249-8737
Phone (336) 275-7328

Other identifiers 1

IdentifierTypeStateIssuer
MHL-041-779MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sedalia Center 17 organizations share this tax ID, including this one
Part of
Sedalia Center 1

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1790997542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 BLUE LANTERN RD",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272498737",
            "telephone_number": "336-275-7328",
            "fax_number": "336-272-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6141 BLUE LANTERN RD",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272498737",
            "telephone_number": "336-275-7328",
            "fax_number": "336-272-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDALIA CENTER #1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIGGINS FAMILY CARE INC",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "LIGGINS",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-275-7328",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-041-779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MHL-041-779",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.