E & T Alliance LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-096178 Issued in NC

Legal business name

E & T ALLIANCE LLC

Doing business as

A Healthy Haven

Practice address

410 Marcia Dr
Goldsboro, NC 27530-9213

Phone

(919) 734-9956

NPI assigned

Nov 13, 2006

Last updated

Mar 6, 2009By 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

Mark Ellermeier

Title

President

Phone

(919) 734-9956

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• A Healthy Haven Doing business as

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1861563488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MARCIA DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275309213",
            "telephone_number": "919-734-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MARCIA DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275309213",
            "telephone_number": "919-734-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E & T ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "ELLERMEIER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-734-9956"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-096178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603996",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Healthy Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dva Renal Healthcare Inc (Goldsboro South Dialysis)
• Dwi and Counseling Services, Inc.
• Dwi and Counseling Services, Inc.
• Dwight S. Smith, DDS PA
• Christopher David Dye, PA-C
• Eagle Vision Empowerment Services (Eagle Vision Behavior Health)
• Early Life Learning Center, LLC
• Carmalinda Early, ANP
• George W Eason, MD
• East Carolina Brace & Limb Co., Inc.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.