NPIMap

Organization Active NPI

Essentially Living Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kings Mountain, NC
National Provider Identifier
1952596413
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-023-109 Issued in NC
Legal business name
ESSENTIALLY LIVING INC
Practice address
301 S Battleground Ave
Kings Mountain, NC 28086-3601
Phone
(704) 739-3997
Fax
(704) 739-6420
NPI assigned
Sep 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Mr. Aaron Anderson
Title
Owner
Phone
(704) 913-5779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-023-109 NC Primary

Addresses

Primary practice location

301 S Battleground Ave
Kings Mountain, NC 28086-3601

Mailing address

PO Box 1593
Kings Mountain, NC 28086-1593
Phone (704) 739-3997

Other identifiers 1

IdentifierTypeStateIssuer
6604128MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Essentially Living Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1952596413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1593",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280861593",
            "telephone_number": "704-739-3997",
            "fax_number": "704-739-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S BATTLEGROUND AVE",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863601",
            "telephone_number": "704-739-3997",
            "fax_number": "704-739-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIALLY LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-913-5779",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-023-109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.