Ebenezer Christian Childrens Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-097-061 Issued in NC

Legal business name

EBENEZER CHRISTIAN CHILDRENS HOME

Practice address

1006 Byrd Ridge Rd
North Wilkesboro, NC 28659-8044

Phone

(336) 667-5683

Fax

(336) 667-8634

NPI assigned

Mar 27, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Jean Davis

Title

Executive Director

Phone

(336) 667-5683

Specialties & licenses 1

Addresses

Other names 1

• Ebenezer Garden Christian Childrens Home Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Cain, MA. LMFT

  • Counselor
  • N Wilkesboro, NC
  • NPI 1669525846
  NPD (past)

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1881866002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2777",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286592777",
            "telephone_number": "336-667-5683",
            "fax_number": "336-667-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 BYRD RIDGE RD",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286598044",
            "telephone_number": "336-667-5683",
            "fax_number": "336-667-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER CHRISTIAN CHILDRENS HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-667-5683",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-097-061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ebenezer Garden Christian Childrens Home",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hayleigh Dreaney-Power, CADC-I
• Reshana Lynne Dupree, PMHNP-BC
• Gregg Eady
• Easter Seals Ucp North Carolina & Virginia Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Eckerd Corporation
• Ginna Edwards, PA-C
• Elevate Chiropractic and Performance Therapy PLLC
• Angela Shew Elledge, OT/L
• Aletha Poplin Eller, PHARMD

• Emotionally Disturbed Childrens' Residential Treatment Facility in North Wilkesboro, NC
• Providers in North Wilkesboro, 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 27, 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.