NPIMap

Organization Active NPI

Tar Heel Habilitation Services LLC

  • Developmentally Disabled Services Day Training Agency
  • Salisbury, NC
National Provider Identifier
1891946182
Registry record updated Oct 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
MHL-080-175 Issued in NC
Legal business name
TAR HEEL HABILITATION SERVICES LLC
Practice address
512 Klumac Rd
Suite #2
Salisbury, NC 28144-6758
Phone
(704) 431-4649
NPI assigned
Oct 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2008

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

Authorized official

Name
Mr. Andre Paul Gaston, J.D.
Title
Executive Director
Phone
(704) 431-4649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MHL-080-175 NC Primary

Addresses

Primary practice location

512 Klumac Rd
Suite #2
Salisbury, NC 28144-6758

Mailing address

512 Klumac Rd
Suite #2
Salisbury, NC 28144-6758
Phone (704) 431-4649

Other names 1

  • Tar Heel Day Services & Respite Division Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolina Health Day Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

512 Klumac Rd
Ste 2
Salisbury, NC 28144
Phone (704) 431-4649

NPI Registry JSON

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

{
    "created_epoch": "1223078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223078400000",
    "number": "1891946182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 KLUMAC RD",
            "address_2": "SUITE #2",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446758",
            "telephone_number": "704-431-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 KLUMAC RD",
            "address_2": "SUITE #2",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446758",
            "telephone_number": "704-431-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAR HEEL HABILITATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-04",
        "last_updated": "2008-10-04",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-431-4649",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL-080-175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tar Heel Day Services & Respite Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.