Cozie's Supervised Living Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-001-074 Issued in NC

Legal business name

COZIE'S SUPERVISED LIVING INC.

Practice address

7964 County Line Rd
Liberty, NC 27298-9590

Phone

(336) 549-1081

Fax

(336) 622-1420

NPI assigned

Feb 15, 2007

Last updated

Jun 16, 2008By 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

Mrs. Crystal Dudley

Title

Administrator

Phone

(336) 549-1081

Specialties & licenses 6

Addresses

Other identifiers 3

Tax ID family

Cozie's Supervised Living Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cozie's Supervised Living Inc

  • Psychiatric Residential Treatment Facility
  • Liberty, NC
  • NPI 1770727281
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Francis Kwasi Ndinya, MS., CRC., LCMHC.

  • Mental Health Counselor
  • Greensboro, NC
  • NPI 1891244380
  NPD

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1891838116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7964 COUNTY LINE RD",
            "city": "LIBERTY",
            "state": "NC",
            "postal_code": "272989590",
            "telephone_number": "336-549-1081",
            "fax_number": "336-622-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7964 COUNTY LINE RD",
            "city": "LIBERTY",
            "state": "NC",
            "postal_code": "272989590",
            "telephone_number": "336-549-1081",
            "fax_number": "336-622-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COZIE'S SUPERVISED LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-549-1081",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-001-074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803981",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301579",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409308",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cawh Rehabilitation Services, LLC. (Cawh Physical Therapy)
• Janice Lanette Christenbury
• Community Innovations Inc
• Nathan W Conroy, PA-C
• Cozie's Supervised Living Inc
• Ashley Brooke Crutchfield, FNP-C
• Curanex LLC
• Kaylee Renee Dillon
• Dr Thomas Blake Inc
• Dr. Thomas L Blake PA

• Community/Behavioral Health Agency in Liberty, NC
• Providers in Liberty, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.