NPIMap

Organization Active NPI

Community Innovations Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Climax, NC
National Provider Identifier
1841377926
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
MHL076023 Issued in NC
Legal business name
COMMUNITY INNOVATIONS INC
Practice address
5691 Mack Lineberry Road
Climax, NC 27233-8076
Phone
(336) 685-4955
NPI assigned
Nov 1, 2006
Last updated
Sep 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Ms. Mary Benson
Title
Revenue Cycle Director
Phone
(365) 535-9463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL076023 NC Primary

Addresses

Primary practice location

5691 Mack Lineberry Road
Climax, NC 27233-8076

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3220
Phone (919) 256-0824

Other identifiers 1

IdentifierTypeStateIssuer
340608TMedicaidNC

Other names 1

  • Timberlea Group Home Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841377926. Details of each certification follow.

  • CCN 34G307 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 34G307

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
TIMBERLEA GROUP HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 23, 1994
Last certification
Mar 5, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
5691 Mack Lineberry Road
Climax, NC 27233

National Provider Directory

National Provider Directory
Tax ID family
Friendway Group Home48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1841377926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123220",
            "telephone_number": "919-256-0824",
            "fax_number": "919-256-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 MACK LINEBERRY ROAD",
            "city": "CLIMAX",
            "state": "NC",
            "postal_code": "272338076",
            "telephone_number": "336-685-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INNOVATIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "365-535-9463",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL076023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340608T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timberlea Group Home",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Timberlea Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Climax, NC

Sources for this page

Verify at the official NPI Registry.