NPIMap

Organization Active NPI

Community Assisted Residential Environment LLC

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1811042401
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-029-095 Issued in NC
Legal business name
COMMUNITY ASSISTED RESIDENTIAL ENVIRONMENT LLC
Practice address
1381 Old Mill Cir
Suite 301
Winston Salem, NC 27103-1400
Phone
(336) 760-1184
Fax
(336) 760-1727
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Mrs. Shandra Cromartie
Title
Director of Operations
Phone
(336) 760-1184

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-034-172 NC
Community/Behavioral Health Agency 251S00000X MHL-029-095 NC Primary

Addresses

Primary practice location

1381 Old Mill Cir
Suite 301
Winston Salem, NC 27103-1400

Mailing address

1381 Old Mill Cir
Suite 301
Winston Salem, NC 27103-1400
Phone (336) 760-1184

Other identifiers 7

IdentifierTypeStateIssuer
3409208MedicaidNC
8300661AMedicaidNC
8300661HMedicaidNC
8300661GMedicaidNC
7804690MedicaidNC
8300661BMedicaidNC
8300661MedicaidNC

Other names 1

  • CARE Other name

National Provider Directory

National Provider Directory

Locations

1381 Old Mill Cir
Ste 301
Winston Salem, NC 27103
Phone (336) 760-1184

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1811042401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 OLD MILL CIR",
            "address_2": "SUITE 301",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031400",
            "telephone_number": "336-760-1184",
            "fax_number": "336-760-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 OLD MILL CIR",
            "address_2": "SUITE 301",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031400",
            "telephone_number": "336-760-1184",
            "fax_number": "336-760-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ASSISTED RESIDENTIAL ENVIRONMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "CROMARTIE",
        "authorized_official_first_name": "SHANDRA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "336-760-1184",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-034-172",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-029-095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409208",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300661A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300661H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300661G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804690",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300661B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300661",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.