Active NPI
Life Enrichment Center of Cleveland County, Inc.
- Developmentally Disabled Services Day Training Agency
- Shelby, NC
National Provider Identifier
1942364864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- LIFE ENRICHMENT CENTER OF CLEVELAND COUNTY, INC.
- Practice address
- 103 T R Harris Dr
Shelby, NC 28150-3486 - Phone
- (704) 484-0405
- Fax
- (704) 484-0406
- NPI assigned
- Dec 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Suzi Kennedy
- Title
- Executive Director
- Phone
- (704) 484-0405
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary |
Addresses
Primary practice location
103 T R Harris Dr
Shelby, NC 28150-3486
Mailing address
103 T R Harris Dr
Shelby, NC 28150-3486
Phone (704) 484-0405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8301035 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Life Enrichment Center of Cleveland County Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- Shelby, NC
- NPI 1912103532
-
- Adult Day Care Clinic/Center
- Shelby, NC
- NPI 1801937552
Locations
103 T R Harris Dr
Shelby, NC 28150
Phone (704) 484-0405
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Adult Day Care Clinic/Center
- Shelby, NC
- NPI 1801937552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1942364864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 T R HARRIS DR",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503486",
"telephone_number": "704-484-0405",
"fax_number": "704-484-0406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 T R HARRIS DR",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503486",
"telephone_number": "704-484-0405",
"fax_number": "704-484-0406"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE ENRICHMENT CENTER OF CLEVELAND COUNTY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KENNEDY",
"authorized_official_first_name": "SUZI",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "704-484-0405"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8301035",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.